| NPI | 1902683840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANITA MICHELLE JEFFERSON Owner 803-315-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-11-07 |