Provider Demographics
NPI:1710525183
Name:CHILTON COUNTY TREATMENT CENTER
Entity Type:Organization
Organization Name:CHILTON COUNTY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:STAATS
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS IN EDUCATION
Authorized Official - Phone:205-755-4300
Mailing Address - Street 1:2100 HOLIDAY INN DR
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35046-6200
Mailing Address - Country:US
Mailing Address - Phone:205-755-4300
Mailing Address - Fax:205-280-1695
Practice Address - Street 1:2100 HOLIDAY INN DR
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35046-6200
Practice Address - Country:US
Practice Address - Phone:205-755-4300
Practice Address - Fax:205-280-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health