MEDICARE: FAFLI INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1366683203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAFLI INC

Provider Business Mailing Address
First Line	:	2601 READ ST
Second Line	:	SUITE I-2
City	:	COLUMBIA
State	:	SC
Zip	:	29204-7861
Country	:	US
Telephone Number	:	803-834-7100
Fax Number	:	803-834-7102

Provider Business Practice Location Address
First Line	:	2601 READ ST
Second Line	:	SUITE I-2
City	:	COLUMBIA
State	:	SC
Zip	:	29204-7861
Country	:	US
Telephone Number	:	803-834-7100
Fax Number	:	802-834-7102

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. FRANKLIN IGWILO
Credential	:
Telephone Number	:	704-999-2089

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	08/11/2009

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Directions to “FAFLI INC ” Practice Location

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