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General NPI Number Information
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NPI Number | 1750256806
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 932 BANK ST
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City | NEW LONDON
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State | CT
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Zip | 06320-2703
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Country | US
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Telephone | 860-294-9586
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MONTAUK AVE STE 300
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City | NEW LONDON
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State | CT
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Zip | 06320-4967
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Country | US
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Telephone | 860-294-9586
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | STACEY LYNN LAWTON
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Credential |
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Telephone | 860-579-3616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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