Provider Demographics
NPI:1235324245
Name:COCAINE ALCOHOL AWARENESS PROGRAM, INC.
Entity Type:Organization
Organization Name:COCAINE ALCOHOL AWARENESS PROGRAM, INC.
Other - Org Name:CAAP INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:LADAC/NADAC
Authorized Official - Phone:901-360-0442
Mailing Address - Street 1:4041 KNIGHT ARNOLD RD
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-2128
Mailing Address - Country:US
Mailing Address - Phone:901-360-0442
Mailing Address - Fax:901-360-0865
Practice Address - Street 1:4023 KNIGHT ARNOLD RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2128
Practice Address - Country:US
Practice Address - Phone:901-367-7550
Practice Address - Fax:901-272-9519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000135324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility