Provider Demographics
NPI:1124529466
Name:ADVANCES IN MENTAL HEALTH & ADDICTIONS TREATMENT CTR
Entity type:Organization
Organization Name:ADVANCES IN MENTAL HEALTH & ADDICTIONS TREATMENT CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-810-2221
Mailing Address - Street 1:PO BOX 5576
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90721-5576
Mailing Address - Country:US
Mailing Address - Phone:562-365-2020
Mailing Address - Fax:
Practice Address - Street 1:5199 E PACIFIC COAST HWY STE 330N
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3353
Practice Address - Country:US
Practice Address - Phone:562-365-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder