Organization
CHEMICAL DEPENDENCY SERVICES, INC
Active
Other names
Chemical Dependency & Court Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER LYNDON BECK III (DIRECTOR)
(704) 289-4877
Entity
Organization
Contact information
Practice address
308 W. WINDSOR STREET, MONROE, NC 28112-4779
(704) 289-4887
(704) 289-5188
Mailing address
308 W. WINDSOR STREET, MONROE, NC 28112-4779
(704) 289-4887
(704) 289-5188
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
MHL-090-058
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MHL-090-162
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050089
FACILITY ID
NC
01
—
50315
DWI PROVIDER
NC
01
—
MHL-090-058
LICENSE NUMBER
NC
Enumeration date
04/17/2007
Last updated
02/05/2009
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