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General NPI Number Information
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NPI Number | 1124529466
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Entity Type | Organization
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Legal Business Name | ADVANCES IN MENTAL HEALTH & ADDICTIONS TREATMENT CTR
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5199 E PACIFIC COAST HWY STE 330N
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City | LONG BEACH
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State | CA
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Zip | 90804-3353
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Country | US
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Telephone | 562-365-2020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5576
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City | LOS ALAMITOS
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State | CA
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Zip | 90721-5576
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Country | US
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Telephone | 562-365-2020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BENJAMIN STEPANOFF
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Credential | PSYD
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Telephone | 562-810-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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