Provider Demographics
NPI:1063661965
Name:JOHARI FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:JOHARI FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:INNISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-897-3000
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:COATS
Mailing Address - State:NC
Mailing Address - Zip Code:27521-0878
Mailing Address - Country:US
Mailing Address - Phone:910-897-3000
Mailing Address - Fax:
Practice Address - Street 1:27 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:COATS
Practice Address - State:NC
Practice Address - Zip Code:27521-0878
Practice Address - Country:US
Practice Address - Phone:910-897-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health