| NPI | 1972971117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN WITKOWSKI Executive Director 803-713-0806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: SC 14008) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2015-09-04 |