| NPI | 1043395346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTINA MAYO CEO 843-488-6364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: SC 20075227) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-12-22 |