| NPI | 1649843657 |
|---|---|
| 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 | 2021-07-19 |
| Last Update Date | 2025-04-10 |