Provider Demographics
NPI:1285881698
Name:SUBSTANCE ABUSE COUNCIL OF NORTWEST ALABAMA, INC.
Entity type:Organization
Organization Name:SUBSTANCE ABUSE COUNCIL OF NORTWEST ALABAMA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:V
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:256-247-1222
Mailing Address - Street 1:PO BOX 1020
Mailing Address - Street 2:54 WHEELER HILLS ROAD
Mailing Address - City:ROGERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35652-1020
Mailing Address - Country:US
Mailing Address - Phone:256-247-1222
Mailing Address - Fax:256-247-1226
Practice Address - Street 1:54 WHEELER HILLS RD
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35652-7911
Practice Address - Country:US
Practice Address - Phone:256-247-1222
Practice Address - Fax:256-247-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder