| NPI | 1962114827 |
|---|---|
| Doing Business As | CANDACE SMITH JACKSON |
| Entity Type | Organization |
| Authorized Contact | CANDACE SMITH JACKSON Owner 864-395-6786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2022-12-21 |