# FAMILY WELLNESS CENTER OF CHARLESTON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619367745
- **Authorized official:** STANIA A DEJESUS DO (OWNER)
- **Authorized official phone:** (843) 729-8269

## Contact information

- **Practice address:** 9217 UNIVERSITY BLVD, C1B, NORTH CHARLESTON, SC 29406-9147
- **Practice address phone:** (843) 729-8269
- **Mailing address:** 9217 UNIVERSITY BLVD, C1B, NORTH CHARLESTON, SC 29406-9147
- **Mailing address phone:** (843) 729-8269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 1175 | SC | Yes |

## Other

- **Enumeration date:** 01/27/2015
- **Last updated:** 01/27/2015