Provider Demographics
NPI:1326340522
Name:ALCOHOL & DRUG ABUSE COUNCIL
Entity Type:Organization
Organization Name:ALCOHOL & DRUG ABUSE COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANDGEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-634-5753
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75902-0384
Mailing Address - Country:US
Mailing Address - Phone:936-643-5753
Mailing Address - Fax:936-639-2638
Practice Address - Street 1:304 N RAGUET ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3017
Practice Address - Country:US
Practice Address - Phone:936-634-5753
Practice Address - Fax:936-639-2638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health