| NPI | 1972753622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWNEY DIVELY Administrator 803-366-4848 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 36) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |