Provider Demographics
NPI:1932387685
Name:JUVENILE DRUG COURT
Entity Type:Organization
Organization Name:JUVENILE DRUG COURT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE CHIEF II
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-935-6307
Mailing Address - Street 1:301 CITY DRIVE SOUTH, SECOND FLOOR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18992 FLORIDA ST APT F7
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6072
Practice Address - Country:US
Practice Address - Phone:714-935-6307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health