Healthcare Provider Details

I. General information

NPI: 1851666275
Provider Name (Legal Business Name): U-TURN ALCOHOL & DRUG EDUCATION PROGRAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 05/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E ALONDRA BLVD ROOM 102
COMPTON CA
90221-4306
US

IV. Provider business mailing address

3761 STOCKER ST SUITE 105
LOS ANGELES CA
90008-5111
US

V. Phone/Fax

Practice location:
  • Phone: 310-898-6040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE VARNADOE JR.
Title or Position: COO
Credential:
Phone: 323-294-4261