Provider Demographics
NPI:1285108001
Name:ALTERNATIVE DRIG & ALCOHOL COUNSELING LLC
Entity type:Organization
Organization Name:ALTERNATIVE DRIG & ALCOHOL COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:NCAC II, SAP, CAD-AD
Authorized Official - Phone:301-766-0065
Mailing Address - Street 1:370 VIRGINIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740
Mailing Address - Country:US
Mailing Address - Phone:301-766-0065
Mailing Address - Fax:301-766-9594
Practice Address - Street 1:324 E ANTIETAM ST STE 308
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5768
Practice Address - Country:US
Practice Address - Phone:301-766-0065
Practice Address - Fax:301-797-8610
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE DRUG AND ALCOHOL COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-15
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty