Provider Demographics
NPI:1356960512
Name:LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE
Entity type:Organization
Organization Name:LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-777-7500
Mailing Address - Street 1:12070 TELEGRAPH RD STE 207
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-8213
Mailing Address - Country:US
Mailing Address - Phone:562-777-7500
Mailing Address - Fax:
Practice Address - Street 1:8919 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-3013
Practice Address - Country:US
Practice Address - Phone:323-564-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-08
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility