| NPI | 1346638483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA R DAVIS CEO 843-663-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |