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General NPI Number Information
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NPI Number | 1447583984
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Entity Type | Organization
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Legal Business Name | FLORENCE COUNTY COMMISSION ON ALCOHOL AND DRU
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | 601 GREGG AVENUE
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City | FLORENCE
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State | SC
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Zip | 29501
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Country | US
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Telephone | 843-665-3928
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Fax | 843-667-1615
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Provider Business Mailing Address
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Address Line | PO BOX 6196
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City | FLORENCE
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State | SC
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Zip | 29502
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Country | US
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Telephone | 843-665-3929
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Fax | 843-667-1615
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Authorized Official
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Title or Position | CEO
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Name | MR. RANDALL CRAIG COLE
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Credential |
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Telephone | 843-665-9349
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 101Y00000X
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License Number State | SC
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