| NPI | 1982412458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTINA MAYO CEO 843-488-6034 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2024-12-30 |