Provider Demographics
NPI:1780803411
Name:U-TURN DRUG EDUCATION PROGRAM
Entity type:Organization
Organization Name:U-TURN DRUG EDUCATION PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNADOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-462-5028
Mailing Address - Street 1:17420 AVALON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1564
Mailing Address - Country:US
Mailing Address - Phone:310-462-5028
Mailing Address - Fax:310-532-5272
Practice Address - Street 1:3761 STOCKER ST
Practice Address - Street 2:SUITE 105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5111
Practice Address - Country:US
Practice Address - Phone:323-294-4261
Practice Address - Fax:323-294-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560003DN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility