| NPI | 1982117750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY A LAND Owner 803-386-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |