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General NPI Number Information
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NPI Number | 1487869632
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Entity Type | Organization
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Legal Business Name | AUSTIN DRUG AND ALCOHOL ABUSE PROGRAM INC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 7801 N LAMAR BLVD SUITE D-109
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City | AUSTIN
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State | TX
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Zip | 78752-1016
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Country | US
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Telephone | 512-454-8180
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Fax | 512-454-7441
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Provider Business Mailing Address
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Address Line | 7801 N LAMAR BLVD SUITE D-109
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City | AUSTIN
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State | TX
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Zip | 78752-1016
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Country | US
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Telephone | 512-454-8180
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Fax | 512-454-7441
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAN GRANT DAVEY
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Credential | LCDC, SAP
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Telephone | 512-454-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 654A
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License Number State | TX
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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 | 654-3266
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License Number State | TX
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