| NPI | 1891814943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUPERT JAMES MCCORMAC Owner 864-288-7636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: SC SC-10025-M) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |