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General NPI Number Information
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NPI Number | 1477161149
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Entity Type | Organization
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Legal Business Name | ASIAN AMERICAN DRUG ABUSE PROGRAM, INC
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 4625 CRENSHAW BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90043-1209
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Country | US
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Telephone | 323-596-2310
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Fax | 323-596-2317
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Provider Business Mailing Address
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Address Line | 2900 CRENSHAW BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90016-4265
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Country | US
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Telephone | 323-596-2310
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JOSE ESQUEDA
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Credential |
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Telephone | 323-596-2310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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