| NPI | 1922811843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE BRUNSON Owner/Operator 803-460-8545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-01-27 |