Organization
FETTER HEALTH CARE NETWORK INC.
Active
Other names
Chichora Life Center
Organization subpart
No
Provider details
NPI number
Authorized official
REUBEN PETTIFORD (CEO)
(843) 722-4112
Entity
Organization
Contact information
Practice address
3600 RIVERS AVE, NORTH CHARLESTON, SC 29405-7747
(843) 772-4112
Mailing address
51 NASSAU ST, CHARLESTON, SC 29403-5513
(843) 722-4112
(843) 577-8960
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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