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General NPI Number Information
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NPI Number | 1710308531
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Entity Type | Organization
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Legal Business Name | CALIFORNIA HISPANIC COMMISSION ON ALCOHOL & DRUG ABUSE
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 832 S ANAHEIM BLVD
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City | ANAHEIM
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State | CA
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Zip | 92805-5201
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Country | US
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Telephone | 714-772-5580
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Fax | 714-772-1685
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Provider Business Mailing Address
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Address Line | 1905 N. COLLEGE STREET, SUITE A
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City | SANTA ANA
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State | CA
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Zip | 92706
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Country | US
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Telephone | 714-479-0120
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Fax | 714-479-0153
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Authorized Official
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Title or Position | PROJECT DIRECTOR
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Name | MS. LISSETTE VASQUEZ
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Credential |
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Telephone | 714-479-0720
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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 | 300010BN
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License Number State | CA
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