LIONS DEN RECREATION CENTER, THE (NPI# 1174903009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174903009 |
| Entity Type | Organization |
| Organization Name | LIONS DEN RECREATION CENTER, THE |
| Other Organization Name | LIONS DEN, THE |
| Practice Address |
4159 Dorchester Rd Suite B North Charleston SC 29405-7426 |
| Mailing Address |
4159 Dorchester Rd Suite B North Charleston SC 29405 |
| Practice Telephone | 8437183064 |
| Practice Fax Number | 8437183064 |
| Mailing Telephone | 8437183064 |
| Mailing Fax Number | 8437183064 |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |
| Authorized Official Name | H. CRAIG JACKSON (DIRECTOR OF REHABILITATION SERVICES) |
| Authorized Official Telephone | 8438199470 |
| Authorized Official Credential | COTA/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 173000000X | Legal Medicine | 981 | SC | Other Service Providers |
| N | 251V00000X | Voluntary or Charitable | 981 | SC | Agencies |
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | 981 | SC | Hospital Units |
| N | 291U00000X | Clinical Medical Laboratory | 981 | SC | Laboratories |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 981 | SC | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Lions Den, The | Doing Business As Name - Organization |
| Street Address |
4159 DORCHESTER RD SUITE B |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29405-7426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720535 | Detyens Medical Center | Pharmacy | 1670 Drydock Avenue, Building 10, Suite A, North Charleston, SC 29405 | 2020-11-03 |
| 1013422674 | Caroline Rae | Speech-Language Pathologist | 3100 Carner Avenue, Charleston, SC 29405 | 2017-12-05 |
| 1245685171 | Ethel Jane Amerson | Registered Nurse | 3180 Thomasena Mcpherson Blvd, Nursing Module, Charleston County School Districe, North Charleston, SC 29405 | 2016-04-28 |
| 1750755468 | Diane Levesque | Registered Nurse | 4050 Bridgeview Drive, Suite 600, North Charleston, SC 29405 | 2015-11-18 |
| 1063813111 | Trident Medical Center, LLC | Clinic/Center | 5249 Emmett I. Davis Jr. Avenue, North Charleston, SC 29405 | 2014-09-09 |
| 1114344504 | Bonita Davies | Registered Nurse | 3180 Thomasina Mcpherson Boulevard, North Charleston, SC 29405 | 2014-03-24 |
| 1427493261 | Melissa Hancock D'arcy | Registered Nurse | 3750 Dorchester Road, N. Charleston, SC 29405 | 2013-05-07 |
| 1427308824 | Terri Timmerman | Pharmacist | 1506 Montague Ave, North Charleston, SC 29405 | 2012-09-12 |
| 1649414285 | Roper Saint Francis Physicians Network | Clinical Medical Laboratory | 4450 Leeds Place West, Suite A, North Charleston, SC 29405 | 2009-04-27 |
| 1891940649 | Earnestine Roberts | Registered Nurse | 3605 Meeting Street Rd., Ste.b1, North Charleston, SC 29405 | 2008-11-20 |
| Find all providers in zip 29405 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457800310 | Summit Bhc Cameron, LLC | Substance Abuse Rehabilitation Facility | 5401 Netherby Ln Ste 402, North Charleston, SC 29420-7363 | 2016-10-03 |
| 1609008713 | Steve Austin Facility of Charleston | Substance Abuse Rehabilitation Facility | 1383 Remount Rd, North Charleston, SC 29406-3345 | 2009-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972143485 | Landmark Recovery of Columbia LLC | Substance Abuse Rehabilitation Facility | 140 Flora Dr, Columbia, SC 29223-5814 | 2020-01-13 |
| 1235686833 | Summit Bhc Cameron, LLC | Substance Abuse Rehabilitation Facility | 499 Wild Hearts Road, Cameron, SC 29030 | 2016-09-01 |
| 1659776664 | Katonya Alford | Substance Abuse Rehabilitation Facility | 505 N 5th Ave, Dillon, SC 29536-2815 | 2014-11-03 |
| 1063681591 | Givebac Incorporated | Substance Abuse Rehabilitation Facility | 1481 Ted Melton Rd, Chesterfield, SC 29709-6313 | 2008-02-28 |
| 1134158231 | Horry County Comm On Alcohol & Drug Abuse | Substance Abuse Rehabilitation Facility | 2404 Wise Rd, Conway, SC 29526-5521 | 2006-07-01 |
| 1770572448 | Tri-county County Commission On Alcohol and Drug Abuse | Substance Abuse Rehabilitation Facility | 910 Cook Rd, Orangeburg, SC 29118-2124 | 2005-10-17 |
| 1487653606 | Beaufort County Alcohol & Drug Abuse Department | Substance Abuse Rehabilitation Facility | 1905 Duke St, Ste 270, Beaufort, SC 29902-4403 | 2005-07-19 |
| 1861496234 | Department of Alcohol and Other Drug Abuse Services | Substance Abuse Rehabilitation Facility | 5 Charleston Center Dr, Charleston, SC 29401-1162 | 2005-06-13 |
| 1568096329 | Tanya C Hatton | Substance Abuse Rehabilitation Facility | 2711 Colonial Dr, Columbia, SC 29203-6818 | 2020-03-02 |
| 1578105979 | Solutions Recovery Counseling, Inc | Substance Abuse Rehabilitation Facility | 207 W Antrim Dr, Greenville, SC 29607-2329 | 2019-10-17 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.