Healthcare Provider Details

I. General information

NPI: 1376894857
Provider Name (Legal Business Name): FREE N ONE, A DRUG AND ALCOHOL FREE PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 S WILMINGTON AVE
COMPTON CA
90222-1220
US

IV. Provider business mailing address

5838 OVERHILL DR STE. 3
LOS ANGELES CA
90043-2725
US

V. Phone/Fax

Practice location:
  • Phone: 323-295-0009
  • Fax: 323-295-0022
Mailing address:
  • Phone: 323-295-0009
  • Fax: 323-295-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name: YOLONDA SIMMONS
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 323-295-0009