| NPI | 1194322586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK VINSON CFO 843-656-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |