| NPI | 1063079549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTINA MAYO CEO 843-488-6364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-12-22 |