Ichep,llc

NPI #1225290109 in Columbia, South Carolina

Provider Information

NPI Number: 1225290109
Entity Type: Organization
Organization Name: Ichep,llc
Primary Specialty: Psychiatric Hospital
Enumeration Date: Jul 1, 2008
Last Updated: Jul 1, 2008

Practice Location

Address: 3555 HARDEN STREET EXT
Address 2: EXT., SUITE B18
City: Columbia
State: South Carolina
ZIP Code: 29203-6894
Phone: (803) 477-7928

Authorized Official

Name: DR. SHAKA ABDUL MOUSTAFA I, PH.D
Title: CEO
Phone: (803) 477-7928

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychiatric Hospital	283Q00000X	Primary

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