| NPI | 1508120619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DAVIS CEO 843-663-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2024-01-16 |