| NPI | 1891270872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN DAVID LASZCZYNSKI Managing Partner 803-719-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2020-07-09 |