Basic Information
| Provider Information | |||||||||
| NPI: | 1013254754 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADAPT PROGRAMS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 474 | ||||||||
| Address2: | |||||||||
| City: | ANGLETON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775160474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9794803327 | ||||||||
| FaxNumber: | 2813775870 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 8TH ST | ||||||||
| Address2: | SUITE 8-B | ||||||||
| City: | BAY CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774144962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9794803327 | ||||||||
| FaxNumber: | 2813775870 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2013 | ||||||||
| LastUpdateDate: | 01/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | GARDZINA | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | MATTHEW | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9794803327 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCDC/ SAP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | 261QM1300X | 3592 | TX | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 261QR0401X | 3592 | TX | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.