| NPI | 1770668824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADIE HOLMES Credentialing Adminstrator 843-488-6364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2024-07-05 |