Provider Demographics
NPI:1891795738
Name:GREENVILLE COUNTY COMMISSION ON ALCOHOL AND DRUG ABUSE
Entity Type:Organization
Organization Name:GREENVILLE COUNTY COMMISSION ON ALCOHOL AND DRUG ABUSE
Other - Org Name:THE PHOENIX CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-467-3742
Mailing Address - Street 1:P O BOX 1948
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-1948
Mailing Address - Country:US
Mailing Address - Phone:864-467-3790
Mailing Address - Fax:864-467-3779
Practice Address - Street 1:130 INDUSTRIAL DR STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3241
Practice Address - Country:US
Practice Address - Phone:864-467-3770
Practice Address - Fax:864-467-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder