MEDICARE: LOS ANGELES CENTER FOR ALCOHOL AND DRUG ABUSE

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	171M00000X	Case Manager/Care Coordinator
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1932899861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES CENTER FOR ALCOHOL AND DRUG ABUSE

Provider Business Mailing Address
First Line	:	12070 TELEGRAPH RD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3771
Country	:	US
Telephone Number	:	562-777-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1084 NEW YORK DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3118
Country	:	US
Telephone Number	:	562-777-7500
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JUAN M NAVARRO
Credential	:
Telephone Number	:	562-777-7500

Provider Enumeration Date	:	05/12/2023
Last Update Date	:	02/23/2026

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