Provider Demographics
NPI:1194150375
Name:ASIAN AMERICAN DRUG ABUSE PROGRAM, INC
Entity type:Organization
Organization Name:ASIAN AMERICAN DRUG ABUSE PROGRAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-294-4932
Mailing Address - Street 1:2900 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-4265
Mailing Address - Country:US
Mailing Address - Phone:323-293-6284
Mailing Address - Fax:323-295-4075
Practice Address - Street 1:1360 E ANAHEIM ST STE 205
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-5517
Practice Address - Country:US
Practice Address - Phone:562-218-9530
Practice Address - Fax:562-200-9616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health