Provider Demographics
NPI:1487653606
Name:BEAUFORT COUNTY ALCOHOL & DRUG ABUSE DEPARTMENT
Entity Type:Organization
Organization Name:BEAUFORT COUNTY ALCOHOL & DRUG ABUSE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:HAIGH
Authorized Official - Last Name:BOYNE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:843-470-4550
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29901-0311
Mailing Address - Country:US
Mailing Address - Phone:843-470-4545
Mailing Address - Fax:843-470-4557
Practice Address - Street 1:1905 DUKE ST
Practice Address - Street 2:STE 270
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-4403
Practice Address - Country:US
Practice Address - Phone:843-470-4545
Practice Address - Fax:843-470-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAD21BEMedicaid