Provider Demographics
NPI:1063623593
Name:DRUG ABUSE ALTERNATIVES CENTER
Entity type:Organization
Organization Name:DRUG ABUSE ALTERNATIVES CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CENTER POINT VICE PRESIDENT, DAAC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-526-2943
Mailing Address - Street 1:2403 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3007
Mailing Address - Country:US
Mailing Address - Phone:707-544-3295
Mailing Address - Fax:707-544-9011
Practice Address - Street 1:2403 PROFESSIONAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3007
Practice Address - Country:US
Practice Address - Phone:707-544-3295
Practice Address - Fax:707-544-9011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRUG ABUSE ALTERNATIVES CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-25
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder