| NPI | 1891069761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANI GREEN Owner 803-554-8638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-063-102) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2016-01-11 |