| NPI | 1992411441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINCY POWELL Managing Partner 803-529-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-01-27 |