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General NPI Number Information
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NPI Number | 1023013729
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Entity Type | Organization
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Legal Business Name | PUTNAM COUNTY ALCOHOL & DRUG COUNCIL, INC.
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 330 KAY LARKIN DR
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City | PALATKA
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State | FL
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Zip | 32177-2307
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Country | US
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Telephone | 386-329-3780
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Fax | 386-385-1269
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Provider Business Mailing Address
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Address Line | 330 KAY LARKIN DR
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City | PALATKA
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State | FL
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Zip | 32177-2307
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Country | US
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Telephone | 386-329-3780
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Fax | 386-385-1269
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Authorized Official
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Title or Position | CHAIRPERSON BOARD OF DIRECTORS
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Name | MRS. JOYCE C MILLER
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Credential |
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Telephone | 386-325-4714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0354AD252601
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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