| NPI | 1982144606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ALLAN SIMMONS Director/Manager 803-586-1752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| 111N00000X Chiropractor | |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 2083A0300X Preventive Medicine Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2021-12-07 |