Provider Demographics
NPI:1669650651
Name:LOS ANGELES CENTERS FOR ALCOHOL & DRUG ABUSE
Entity Type:Organization
Organization Name:LOS ANGELES CENTERS FOR ALCOHOL & DRUG ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIEWEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:562-906-2676
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:562-906-2676
Mailing Address - Fax:
Practice Address - Street 1:11701 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2808
Practice Address - Country:US
Practice Address - Phone:562-868-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder