Provider Demographics
NPI:1659599843
Name:AMERICAN DRUG TREATMENT PROGRAM
Entity Type:Organization
Organization Name:AMERICAN DRUG TREATMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:INEGBENEDION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-753-3939
Mailing Address - Street 1:6200 S FIGUEROA ST
Mailing Address - Street 2:P O BOX 82117
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1024
Mailing Address - Country:US
Mailing Address - Phone:323-753-3939
Mailing Address - Fax:323-753-9889
Practice Address - Street 1:6200 S FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1024
Practice Address - Country:US
Practice Address - Phone:323-753-3939
Practice Address - Fax:323-753-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility