Provider Demographics
NPI:1639553670
Name:LOS ANGELES CENTER FOR ALCOHOL AND DRUG ABUSE
Entity type:Organization
Organization Name:LOS ANGELES CENTER FOR ALCOHOL AND DRUG ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:TARKANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-906-2676
Mailing Address - Street 1:470 E 3RD ST
Mailing Address - Street 2:SUITE A AND B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:470 E 3RD ST
Practice Address - Street 2:SUITE A AND B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1629
Practice Address - Country:US
Practice Address - Phone:213-626-6411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management