| NPI | 1386902542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST JAMES STANLEY WARDLAW CEO 843-335-8291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-09-29 |