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General NPI Number Information
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NPI Number | 1518979202
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Entity Type | Organization
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Legal Business Name | GEORGETOWN COUNTY ALCOHOL & DRUG ABUSE COMMISSION
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 1423 WINYAH ST
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City | GEORGETOWN
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State | SC
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Zip | 29440-4730
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Country | US
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Telephone | 843-546-6081
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Fax | 843-527-1697
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Provider Business Mailing Address
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Address Line | PO BOX 515 1
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City | GEORGETOWN
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State | SC
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Zip | 29442-0515
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Country | US
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Telephone | 843-546-6081
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Fax | 843-527-1697
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RALPHAEL MENSAH CARR
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Credential |
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Telephone | 843-546-6081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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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 |
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License Number State |
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