| NPI | 1285677443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN LEWIS CEO 843-857-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-03-11 |