Provider Demographics
NPI:1174289961
Name:LANCASTER TREATMENT SPECIALISTS, LLC
Entity type:Organization
Organization Name:LANCASTER TREATMENT SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM SPONSOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:864-616-5031
Mailing Address - Street 1:977 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-2188
Mailing Address - Country:US
Mailing Address - Phone:803-745-7001
Mailing Address - Fax:803-745-7002
Practice Address - Street 1:977 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2188
Practice Address - Country:US
Practice Address - Phone:803-745-7001
Practice Address - Fax:803-745-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No3336C0002XSuppliersPharmacyClinic Pharmacy