Provider Demographics
NPI:1710076930
Name:SOUTHERN CALIFORNIA ALCOHOL & DRUG PROGRAMS, INC.
Entity Type:Organization
Organization Name:SOUTHERN CALIFORNIA ALCOHOL & DRUG PROGRAMS, INC.
Other - Org Name:SOUTHEAST COUNCIL ON ALCOHOLISM AND DRUG PROBLEMS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:213-259-0963
Mailing Address - Street 1:11500 PARAMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4530
Mailing Address - Country:US
Mailing Address - Phone:562-923-4545
Mailing Address - Fax:562-862-0918
Practice Address - Street 1:11500 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4530
Practice Address - Country:US
Practice Address - Phone:562-923-4545
Practice Address - Fax:562-862-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA19-023-01-123101YA0400X
CA190011AAN101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty