| Organization Name: | CHARLESTON NEUROSCIENCE INSTITUTE LLC |
| NPI Number: | 1619117678 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC JABLON (PARTNER) |
| Mailing Address: | 9551 Hwy 78 Bldg 700 Suite 103 Ladson |
| State: | SC US |
| Postal Code: | 29406 |
| Phone Number: | 8438205315 |
| Fax Number: | 8438201494 |
| NPI Enumeration Date: | 03/03/2009 |
| NPI Last Update Date: | 03/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |