Healthcare Provider Details

I. General information

NPI: 1982960720
Provider Name (Legal Business Name): ADAPT PROGRAMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W 1ST STREET SUITE B ROOM 1
FREEPORT TX
77541
US

IV. Provider business mailing address

PO BOX 474
ANGLETON TX
77516-0474
US

V. Phone/Fax

Practice location:
  • Phone: 832-457-3540
  • Fax: 281-377-5870
Mailing address:
  • Phone: 832-457-3540
  • Fax: 281-377-5870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH MATTHEW GARDZINA
Title or Position: DIRECTOR
Credential: LCDC
Phone: 979-480-3327