MEDICARE: HELPFUL HANDS DRUG AND ALCOHOL OUTPATIENT PROGRAM 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	251S00000X	Community/Behavioral Health Agency	190770AN	CA

General Provider Information

NPI Number	:	1700129731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPFUL HANDS DRUG AND ALCOHOL OUTPATIENT PROGRAM INC

Provider Business Mailing Address
First Line	:	1249 S LA BREA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1627
Country	:	US
Telephone Number	:	323-931-4647
Fax Number	:	323-931-4748

Provider Business Practice Location Address
First Line	:	1249 S LA BREA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1627
Country	:	US
Telephone Number	:	323-931-4647
Fax Number	:	323-931-4748

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARINE DEGIRMENDJIAN
Credential	:	BA
Telephone Number	:	323-819-9635

Provider Enumeration Date	:	03/28/2013
Last Update Date	:	03/28/2013

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