| NPI | 1982359345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON HAYNES Owner 803-220-4288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-26 |