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General NPI Number Information
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NPI Number | 1053742270
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Entity Type | Organization
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Legal Business Name | CALIFORNIA HISPANIC COMMISSION ON ALCOHOL & DRUG ABUSE
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 12/16/2013
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Provider Practice Location Address
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Address Line | 2436 WABASH AVE
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City | LOS ANGELES
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State | CA
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Zip | 90033-2510
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Country | US
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Telephone | 323-780-8756
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Fax | 323-780-8333
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Provider Business Mailing Address
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Address Line | 3316-3322 W. BEVERLY BLVD.
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City | MONTEBELLO
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State | CA
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Zip | 90640
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Country | US
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Telephone | 323-722-4529
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Fax | 323-722-4450
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Authorized Official
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Title or Position | PROJECT DIRECTOR
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Name | MRS. GERMEEN DUPLESSIS
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Credential | MSW
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Telephone | 323-722-4529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 190065CN
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License Number State | CA
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