Provider Demographics
NPI:1699152991
Name:MAAP
Entity type:Organization
Organization Name:MAAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AOD COUNSELOR 1
Authorized Official - Prefix:MS
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:M1306272236
Authorized Official - Phone:916-394-2323
Mailing Address - Street 1:4241 FLORIN RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2535
Mailing Address - Country:US
Mailing Address - Phone:916-394-2323
Mailing Address - Fax:
Practice Address - Street 1:4241 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2535
Practice Address - Country:US
Practice Address - Phone:916-394-2323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM1306272236251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health