Organization
ANDY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INETTA OETLIA ROBINSON (CEO)
(843) 731-4090
Entity
Organization
Contact information
Practice address
2301 WORSHIP ST, SUITE 3, LITTLE ROCK, SC 29567-0092
(843) 731-4090
Mailing address
2301 WORSHIP ST, SUITE 3, LITTLE ROCK, SC 29567-0092
(843) 731-4090
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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