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General NPI Number Information
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NPI Number | 1417017096
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Entity Type | Organization
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Legal Business Name | ALCOHOL AND DRUG ABUSE SERVICES INC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 120 CHESTNUT STREET
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City | PORT ALLEGANY
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State | PA
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Zip | 16743-1251
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Country | US
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Telephone | 814-642-9541
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Fax | 814-642-9596
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Provider Business Mailing Address
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Address Line | 120 CHESTNUT STREET
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City | PORT ALLEGANY
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State | PA
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Zip | 16743-1251
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Country | US
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Telephone | 814-642-9541
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Fax | 814-642-9596
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. EVAN R DITTMAN
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Credential | B.S
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Telephone | 814-642-2910
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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 | 427024
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 427033
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 427038
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 427034
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 127037
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 241094
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 537034
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License Number State | PA
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