Provider Demographics
NPI:1679848097
Name:U-TURN ALCOHOL & DRUG EDUCATION PROGRAM, INC.
Entity Type:Organization
Organization Name:U-TURN ALCOHOL & DRUG EDUCATION PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNADOE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:323-294-4261
Mailing Address - Street 1:3761 STOCKER ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5111
Mailing Address - Country:US
Mailing Address - Phone:323-294-4261
Mailing Address - Fax:
Practice Address - Street 1:15301 S SAN JOSE AVE
Practice Address - Street 2:NURSE OFFICE/CLINICAL BLDG. R, LIBRARY, AND GYMNASIUM
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3131
Practice Address - Country:US
Practice Address - Phone:562-630-0142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty