| NPI | 1396881066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA CASE Executive Director 803-909-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: SC 42-1033) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: SC 55006721) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-10-19 |