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NPI Code Detail

MEDICARE: DRUG ABUSE ALTERNATIVES CENTER

MEDICARE: DRUG ABUSE ALTERNATIVES CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1568218469
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRUG ABUSE ALTERNATIVES CENTER
Provider Business Mailing Address
First Line : 2403 PROFESSIONAL DR STE 102
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-3007
Country : US
Telephone Number : 707-544-3295
Fax Number :
Provider Business Practice Location Address
First Line : 790 SONOMA AVE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-4713
Country : US
Telephone Number : 707-544-3295
Fax Number :
Authorized Official
Title or Position : REGIONAL VICE PRESIDENT
Name : MICHAEL O'BRIEN
Credential : CADC II, NCAC I
Telephone Number : 707-544-3296
Provider Enumeration Date : 04/30/2024
Last Update Date : 04/30/2024

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Directions to “DRUG ABUSE ALTERNATIVES CENTER ” Practice Location

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