| NPI | 1427363209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA L HAYNES CEO 843-234-8220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 174400000X Specialist | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2025-06-04 |