MEDICARE: ALCOHOL AND SUBSTANCE ABUSE PROGRAMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	190569AP	CA

General Provider Information

NPI Number	:	1689844334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALCOHOL AND SUBSTANCE ABUSE PROGRAMS, INC.

Provider Business Mailing Address
First Line	:	501 CONCHA ST
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-1414
Country	:	US
Telephone Number	:	818-421-7890
Fax Number	:	818-954-2265

Provider Business Practice Location Address
First Line	:	1092 NEW YORK DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3118
Country	:	US
Telephone Number	:	818-421-7890
Fax Number	:	818-954-2265

Authorized Official
Title or Position	:	CEO
Name	:	MR. ARTHUR HARRIS
Credential	:
Telephone Number	:	818-421-7890

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	03/10/2008

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