| NPI | 1720082571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN LEWIS CEO 843-857-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-09-04 |