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General NPI Number Information
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NPI Number | 1902012255
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Entity Type | Organization
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Legal Business Name | METRO TREATMENT OF SOUTH CAROLINA
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 560 CHRIS DR
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4669
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Country | US
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Telephone | 803-791-9422
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Fax | 407-351-6930
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Provider Business Mailing Address
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Address Line | 2500 MAITLAND CENTER PKWY STE 250
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City | MAITLAND
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State | FL
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Zip | 32751-4174
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Country | US
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Telephone | 407-351-7080
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Fax | 407-351-6930
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Authorized Official
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Title or Position | CEO
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Name | JAMES THOMAS SHAHEEN JR.
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Credential |
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Telephone | 407-351-7080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 50004492
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License Number State | SC
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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 | OTPN-026
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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