NPIMap

Organization Active NPI

Florence County Commission on Alcohol and Dru

  • Substance Abuse Rehabilitation Facility
  • Florence, SC
National Provider Identifier
1114922283
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
FLORENCE COUNTY COMMISSION ON ALCOHOL AND DRU
Practice address
601 Greg Avenue
Florence, SC 29501
Phone
(843) 665-3928
Fax
(843) 667-1615
NPI assigned
Jun 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William Russell Terrell Jr.
Title
Deputy Ceo
Phone
(843) 665-9349

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

601 Greg Avenue
Florence, SC 29501

Mailing address

PO Box 6196
Florence, SC 29502
Phone (843) 665-3929

Other identifiers 1

IdentifierTypeStateIssuer
AD04FLMedicaidSC

Other names 1

  • Circle Park Behavioral Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Circle Park Behavioral Health Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

601 Gregg Ave
Florence, SC 29501
Phone (843) 665-9349

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1114922283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6196",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29502",
            "telephone_number": "843-665-3929",
            "fax_number": "843-667-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GREG AVENUE",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-665-3928",
            "fax_number": "843-667-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORENCE COUNTY COMMISSION ON ALCOHOL AND DRU",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "DEPUTY CEO",
        "authorized_official_telephone_number": "843-665-9349",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AD04FL",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Circle Park Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.