| NPI | 1972863496 |
|---|---|
| Other Name | CARTER J STREET |
| Entity Type | Organization |
| Authorized Contact | SIVI BURNS DANIELS Lpn 803-419-1526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: SC PR 38235) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-25 |