| NPI | 1316749617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOVELLA YVETTE JACKSON President 803-878-2478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2025-03-26 |
| Last Update Date | 2025-03-26 |