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NPI Code Detail

MEDICARE: PERRY COUNTY ALCOHOL AND DRUG ABUSE, INC

MEDICARE: PERRY COUNTY ALCOHOL AND DRUG ABUSE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
23245S0500XChildren's Substance Abuse Rehabilitation Facility
3324500000XSubstance Abuse Rehabilitation Facility
4251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457330938
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERRY COUNTY ALCOHOL AND DRUG ABUSE, INC
Provider Business Mailing Address
First Line : 203 N MAIN ST
Second Line :
City : NEW LEXINGTON
State : OH
Zip : 43764-1264
Country : US
Telephone Number : 740-342-1991
Fax Number : 740-342-2914
Provider Business Practice Location Address
First Line : 203 N MAIN ST
Second Line :
City : NEW LEXINGTON
State : OH
Zip : 43764-1264
Country : US
Telephone Number : 740-342-1991
Fax Number : 740-342-2914
Authorized Official
Title or Position : DIRECTOR
Name : RENEA LYNN DODSON
Credential :
Telephone Number : 740-342-1991
Provider Enumeration Date : 01/12/2006
Last Update Date : 11/17/2025

Similar Medicare Providers

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Practice Location Address:
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43764-1264
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1821541657 — THERESSA K SNYDER RN
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203 N MAIN ST
NEW LEXINGTON, OH
43764-1264
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1437692068 — PBHC
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Directions to “PERRY COUNTY ALCOHOL AND DRUG ABUSE, INC ” Practice Location

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