Healthcare Provider Details

I. General information

NPI: 1700383270
Provider Name (Legal Business Name): LOS ANGELES CENTER FOR ALCOHOL AND DRUG ABUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5861 CHERRY AVE
LONG BEACH CA
90805-4405
US

IV. Provider business mailing address

11015 BLOOMFIELD AVE
SANTA FE SPRINGS CA
90670-4601
US

V. Phone/Fax

Practice location:
  • Phone: 562-676-4256
  • Fax:
Mailing address:
  • Phone: 562-906-2686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JUAN NAVARRO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 562-906-2686