Provider Demographics
NPI:1306522701
Name:AMERICAN DTC LLC
Entity type:Organization
Organization Name:AMERICAN DTC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:954-857-8479
Mailing Address - Street 1:405 W CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:CHESNEE
Mailing Address - State:SC
Mailing Address - Zip Code:29323-1008
Mailing Address - Country:US
Mailing Address - Phone:704-241-9250
Mailing Address - Fax:
Practice Address - Street 1:405 W CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:CHESNEE
Practice Address - State:SC
Practice Address - Zip Code:29323-1008
Practice Address - Country:US
Practice Address - Phone:704-241-9250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility