SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC; NPI #1003960022

Contact Information

SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC

37 CAMP MOOWEEN ROAD
LEBANON, CT 06249

Phone: 860-889-1717
Fax: 860-886-2361
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Substance Abuse Disorder Rehabilitation Facility	324500000X
Adult Mental Health	261QM0850X

Indicates primary specialty

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NPI Profile & details for SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC

NPI Number 1003960022

LBN Legal business name SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC

Authorized official STACEY LAWTON - (CHIEF EXECUTIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/23/2007

Last updated 03/09/2026 - About 3 months ago

Identifiers

CT	License #	0439
CT	License #	SA-0018
CT	License #	SA0020
CT	Medicaid	004042073
CT	Medicaid	004144606
CT	Medicaid	008004220
CT	Medicaid	008075943
CT	Medicaid	008109801
CT	Medicaid	008110668
CT	Medicaid	008110670
CT	Medicaid	008132356
CT	Medicaid	008133549

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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