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General NPI Number Information
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NPI Number | 1376720037
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Entity Type | Organization
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Legal Business Name | LOS ANGELES CENTERS FOR ALCOHOL & DRUG ABUSE
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 470 E 3RD ST STE A
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City | LOS ANGELES
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State | CA
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Zip | 90013-1630
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Country | US
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Telephone | 213-626-6411
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Fax | 213-626-8115
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Provider Business Mailing Address
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Address Line | 470 E 3RD ST STE A
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City | LOS ANGELES
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State | CA
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Zip | 90013-1630
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Country | US
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Telephone | 213-626-6411
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Fax | 213-626-8115
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BRENDA WIEWEL
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Credential | LCSW
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Telephone | 562-906-2686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | CA
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