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General NPI Number Information
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NPI Number | 1215338710
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Entity Type | Organization
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Legal Business Name | DORCHESTER ALCOHOL AND DRUG COMMISSION
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 500 N MAIN ST #4
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6439
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Country | US
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Telephone | 843-871-4793
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N MAIN ST #4
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6439
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXCEUTIVE DIRECTOR
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Name | SAMUEL MILLER
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Credential |
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Telephone | 843-871-4793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 10845
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License Number State | SC
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