| NPI | 1609640861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN WARDLAW CEO 803-531-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2025-01-15 |