| NPI | 1831953181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST J WARDLAW CEO 843-335-8291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |