Provider Demographics
NPI:1598940959
Name:ALCOHOL AND DRUG SERVICES
Entity Type:Organization
Organization Name:ALCOHOL AND DRUG SERVICES
Other - Org Name:REIDSVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAU
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA
Authorized Official - Phone:336-882-2125
Mailing Address - Street 1:119 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-6803
Mailing Address - Country:US
Mailing Address - Phone:336-882-2125
Mailing Address - Fax:336-882-8153
Practice Address - Street 1:1419 FREEWAY DR
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-7105
Practice Address - Country:US
Practice Address - Phone:336-339-4336
Practice Address - Fax:336-339-4337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-079-090251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health