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General NPI Number Information
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NPI Number | 1538153069
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Entity Type | Organization
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Legal Business Name | LEXINGTON RICHLAND ALCOHOL & DRUG ABUSE COUNCIL, INC.
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 2711 COLONIAL DRIVE
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City | COLUMBIA
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State | SC
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Zip | 29203
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Country | US
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Telephone | 803-726-9301
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Fax | 803-726-9480
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Provider Business Mailing Address
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Address Line | PO BOX 50597
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City | COLUMBIA
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State | SC
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Zip | 29250-0597
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Country | US
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Telephone | 803-726-9301
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Fax | 803-726-9480
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MS. LINDA G AYCOCK
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Credential | ESQ.
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Telephone | 803-726-9301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | SC
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