| NPI | 1861683542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY DAWN MOORE Intern 803-463-1891 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |