Provider Demographics
NPI:1851367742
Name:ASHLAND COUNTY COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Entity Type:Organization
Organization Name:ASHLAND COUNTY COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:LICDC
Authorized Official - Phone:419-289-7675
Mailing Address - Street 1:310 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3803
Mailing Address - Country:US
Mailing Address - Phone:419-289-7675
Mailing Address - Fax:419-289-2349
Practice Address - Street 1:310 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3803
Practice Address - Country:US
Practice Address - Phone:419-289-7675
Practice Address - Fax:419-289-2349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01010Medicare UPIN