| NPI | 1982265823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA WILLIAMS Owner 843-834-6038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |