| NPI | 1962721886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN WINSTEAD Clinical Director 803-779-0354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: SC 5133) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2010-05-18 |