Provider Demographics
NPI:1457501504
Name:CALIFORNIA DRUG COUNSELING
Entity Type:Organization
Organization Name:CALIFORNIA DRUG COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:626-513-4799
Mailing Address - Street 1:659 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1635
Mailing Address - Country:US
Mailing Address - Phone:626-513-4799
Mailing Address - Fax:
Practice Address - Street 1:659 E.WALNUT ST.
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-513-4799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management