Provider Demographics
NPI:1154832749
Name:LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE
Entity Type:Organization
Organization Name:LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE
Other - Org Name:SAFE HAVEN
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-906-2686
Mailing Address - Street 1:11015 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-4601
Mailing Address - Country:US
Mailing Address - Phone:562-906-2686
Mailing Address - Fax:
Practice Address - Street 1:12580 LAKELAND ROAD
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS,
Practice Address - State:CA
Practice Address - Zip Code:90670
Practice Address - Country:US
Practice Address - Phone:562-906-2686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOS ANGELES CENTER FOR ALCOHOL AND DRUG ABUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-23
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)