SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC
NPI 1003960022
Substance Abuse Rehabilitation Facility in Lebanon, CT
NPI Status: Active since January 23, 2007
Contact Information
37 CAMP MOOWEEN ROAD
LEBANON, CT
ZIP 06249
Phone: (860) 889-1717
Fax: (860) 886-2361
- Organization
- Substance Abuse Rehabilitation Facility
- CLIA Number: 07D1099176
- CLIA Cert. Type: Other - SUBSTANCE ABUSE
- CLIA Exp. Date: 05-06-2027
About SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC
This page provides the complete NPI Profile along with additional information for Southeastern Council On Alcoholism And Drug Dependence Inc, a provider established in Lebanon, Connecticut operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1003960022 assigned on January 2007. The practitioner's primary taxonomy code is 324500000X with license number SA0020 (CT). The provider is registered as an organization and their NPI record was last updated March 2026. The provider's
- NPI
- 1003960022
- Provider Legal Name
- SOUTHEASTERN COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE INC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 37 CAMP MOOWEEN ROAD LEBANON, CT 06249
- Location Phone
- (860) 889-1717
- Location Fax
- (860) 886-2361
- Mailing Address
- 1 MONTAUK AVE STE 301 NEW LONDON, CT 06320
- Mailing Phone
- (860) 447-1717
- Mailing Fax
- (860) 886-2361
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-23-2007
- Last Update Date
- 03-09-2026
- Code Navigator
Location Map
Secondary Locations
- 64 Coit St
New London, CT 06320
(860) 447-1717 - 38 Coit St
New London, CT 06320
(860) 447-1717 - 932 Bank St
New London, CT 06320
(860) 447-1717 - 47 Coit St
New London, CT 06320
(860) 447-1717 - 313 Main St
Norwich, CT 06360
(860) 447-1717 - 40 Coit St
New London, CT 06320
(860) 447-1717
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Substance Abuse Rehabilitation Facility
- Taxonomy Code
- 324500000X
- Type
- Residential Treatment Facilities
- License No.
- SA0020
- License State
- CT
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | 0439 (CT) |
| 2 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | SA-0018 (CT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 008109801 | MEDICAID (05) | CT | |
| 008110670 | MEDICAID (05) | CT | |
| 008110668 | MEDICAID (05) | CT | |
| 004042073 | MEDICAID (05) | CT | |
| 008132356 | MEDICAID (05) | CT | |
| 004144606 | MEDICAID (05) | CT | |
| 008004220 | MEDICAID (05) | CT | |
| 008075943 | MEDICAID (05) | CT | |
| 008133549 | MEDICAID (05) | CT |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D1099176
- Facility Type
- Other - SUBSTANCE ABUSE
- Certificate Effective Date
- May 07, 2025
- Certificate Expiration Date
- May 06, 2027
- Laboratory Director
- ASHLAND HAYES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southeastern Council On Alcoholism And Drug Dependence Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003960022, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003960022, enumerated as an "organization" on January 23, 2007.
The provider is located at 37 CAMP MOOWEEN ROAD LEBANON, CT 06249 and the phone number is (860) 889-1717.
Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
