| NPI | 1407213895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN MATHIS CEO 803-469-4966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: SC 3009386) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-21 |