Healthcare Provider Details

I. General information

NPI: 1659682011
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: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 N WILMINGTON AVE
COMPTON CA
90222-2004
US

IV. Provider business mailing address

5838 OVERHILL DR STE 3
LOS ANGELES CA
90043-2738
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number190447BN
License Number StateCA

VIII. Authorized Official

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