| NPI | 1114344702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUETTE CALDWELL Owner/President 803-917-7302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251V00000X Voluntary or Charitable | |
| 261QA0005X Clinic/Center Ambulatory Family Planning Facility | |
| 261QC1500X Clinic/Center Community Health | |
| 261QC1800X Clinic/Center Corporate Health | |
| 261QE0002X Clinic/Center Emergency Care | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM1000X Clinic/Center Migrant Health | |
| 261QR0200X Clinic/Center Radiology | |
| 261QU0200X Clinic/Center Urgent Care | |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2014-03-21 |