Provider Demographics
NPI:1972532075
Name:LAURENS COUNTY COMMISSION ON ALCOHOL AND DRUG ABUSE
Entity type:Organization
Organization Name:LAURENS COUNTY COMMISSION ON ALCOHOL AND DRUG ABUSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-833-6500
Mailing Address - Street 1:219 HUMAN SERVICES ROAD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325
Mailing Address - Country:US
Mailing Address - Phone:864-833-6500
Mailing Address - Fax:864-833-6905
Practice Address - Street 1:219 HUMAN SERVICES ROAD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325
Practice Address - Country:US
Practice Address - Phone:864-833-6500
Practice Address - Fax:864-833-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOTP-0035261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty