Provider Demographics
NPI:1710490438
Name:PEER DRUG AND ALCOHOL PROGRAM
Entity Type:Organization
Organization Name:PEER DRUG AND ALCOHOL PROGRAM
Other - Org Name:PEER DRUG AND ALCOHOL PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:EDGARDO
Authorized Official - Last Name:JUAREZ MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-253-6588
Mailing Address - Street 1:512 HAMILTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1505
Mailing Address - Country:US
Mailing Address - Phone:267-253-6588
Mailing Address - Fax:484-221-9440
Practice Address - Street 1:512 HAMILTON ST STE 200
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1505
Practice Address - Country:US
Practice Address - Phone:267-253-6588
Practice Address - Fax:484-221-9440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAICES PASTORAL COUNSELING & HUMAN DEVELOPMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-16
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA397067261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)