Healthcare Provider Details

I. General information

NPI: 1134158231
Provider Name (Legal Business Name): HORRY COUNTY COMM ON ALCOHOL & DRUG ABUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 WISE RD
CONWAY SC
29526-5521
US

IV. Provider business mailing address

2404 WISE RD
CONWAY SC
29526-5521
US

V. Phone/Fax

Practice location:
  • Phone: 843-365-8884
  • Fax: 843-365-6697
Mailing address:
  • Phone: 843-365-8884
  • Fax: 843-365-6697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberOTP-016
License Number StateSC

VIII. Authorized Official

Name: MEGAN COLEGROVE
Title or Position: FINANCE
Credential:
Phone: 843-365-8884