| NPI | 1043684632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE FAUL Executive Director 843-237-2672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: SC MD22103) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |