Organization
SOUTHEAST ADDICTION INSTITUTE AND LEARNING CENTER, INC
Active
Other names
SAIL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS GLENN AUSTIN CSAC, CCS (EXECUTIVE DIRECTOR)
(704) 561-0920
Entity
Organization
Contact information
Practice address
5601 EXECUTIVE CENTER DR, SUITE 101, CHARLOTTE, NC 28212-8841
(704) 561-0920
(704) 561-0851
Mailing address
5601 EXECUTIVE CENTER DR, SUITE 101, CHARLOTTE, NC 28212-8841
(704) 561-0920
(704) 561-0851
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MHL-060-587
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005380
—
NC
Enumeration date
05/02/2006
Last updated
08/22/2020
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