| NPI | 1912672296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEILANI LEE CEO 843-276-2019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2021-08-10 |