1851666275 NPI number — U-TURN ALCOHOL & DRUG EDUCATION PROGRAM, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851666275 NPI number — U-TURN ALCOHOL & DRUG EDUCATION PROGRAM, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
U-TURN ALCOHOL & DRUG EDUCATION PROGRAM, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851666275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3761 STOCKER ST
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90008-5111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 E ALONDRA BLVD
Provider Second Line Business Practice Location Address:
ROOM 102
Provider Business Practice Location Address City Name:
COMPTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90221-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-898-6040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2012

Additional Information

Authorized Official

Authorized Official Last Name:
VARNADOE
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
323-294-4261

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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