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Addiction Substance Use Disorder

Sumter, South Carolina

Provider NPI: 1043215569

Organization Information:
Organization is not Subpart
Authorized Official:  GLENN  PEAGLER  EXECUTIVE DIRECTOR  803-7782835

Practice Location:
Tel: 803-775-6815  Fax: 803-773-6232

Business Mailing Address:
Tel: 803-775-6815  Fax: 803-773-6232

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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