Provider Demographics
NPI:1316257181
Name:JAMES ISLAND PRESBYTERIAN FOUNDATION
Entity type:Organization
Organization Name:JAMES ISLAND PRESBYTERIAN FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MEEUWSE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:843-795-3111
Mailing Address - Street 1:1632 FORT JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8822
Mailing Address - Country:US
Mailing Address - Phone:843-795-3111
Mailing Address - Fax:843-795-1508
Practice Address - Street 1:1632 FORT JOHNSON RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-8822
Practice Address - Country:US
Practice Address - Phone:843-795-3111
Practice Address - Fax:843-795-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty