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General NPI Number Information
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NPI Number | 1386233252
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Entity Type | Organization
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Legal Business Name | IN HIS IMAGE OUTREACH
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 700 E SHOCKLEY FERRY RD STE A5
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City | ANDERSON
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State | SC
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Zip | 29624-2937
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Country | US
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Telephone | 864-381-5248
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 413
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City | BELTON
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State | SC
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Zip | 29627-0413
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Country | US
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Telephone | 864-381-5248
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | BEVERLY WHITE
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Credential |
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Telephone | 864-381-5248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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