Basic Information
| Provider Information | |||||||||
| NPI: | 1225468416 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTER FOR ALCOHOL AND DRUG STUDIES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 538135 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303538135 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3153 CANADA CT | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334615517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009900340 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2013 | ||||||||
| LastUpdateDate: | 05/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | HU | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5614651082 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 1550AD256506 | FL | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.