| NPI | 1962400325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD L. RICKENBAKER Director 843-538-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2025-09-11 |