Organization
TRI-COUNTY COUNTY COMMISSION ON ALCOHOL AND DRUG ABUSE
Active
Other names
William J. McCord Adolescent Treatment Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD S FOWLER (EXECUTIVE DIRECTOR)
(803) 536-4900
Entity
Organization
Contact information
Practice address
910 COOK RD, ORANGEBURG, SC 29118-2124
(803) 536-4900
(803) 531-8419
Mailing address
PO BOX 1166, ORANGEBURG, SC 29116-1166
(803) 536-4900
(803) 531-8419
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
619
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M00036SC1
—
SC
Enumeration date
10/17/2005
Last updated
08/02/2010
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