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General NPI Number Information
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NPI Number | 1841412061
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Entity Type | Organization
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Legal Business Name | CENTER FOR BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 182 LAURELHURST AVE
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City | COLUMBIA
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State | SC
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Zip | 29210-3824
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Country | US
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Telephone | 803-551-0060
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Fax | 803-551-0062
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Provider Business Mailing Address
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Address Line | 182 LAURELHURST AVE
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City | COLUMBIA
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State | SC
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Zip | 29210-3824
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Country | US
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Telephone | 803-551-0060
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Fax | 803-551-0062
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANIL K JUNEJA
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Credential | M.D.
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Telephone | 803-551-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | 154371
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License Number State | SC
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