Provider Demographics
NPI:1740457811
Name:ALCOHOL AND DRUG INFORMATION SERVICES LLC
Entity type:Organization
Organization Name:ALCOHOL AND DRUG INFORMATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:BILLS
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC
Authorized Official - Phone:757-620-8536
Mailing Address - Street 1:17577 BEALE PLACE DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-8345
Mailing Address - Country:US
Mailing Address - Phone:757-620-8536
Mailing Address - Fax:
Practice Address - Street 1:2013 CUNNINGHAM DR
Practice Address - Street 2:SUITE 336
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3306
Practice Address - Country:US
Practice Address - Phone:757-620-8536
Practice Address - Fax:757-262-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710101904101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty