Basic Information
Provider Information
NPI: 1538605258
EntityType: 2
ReplacementNPI:  
OrganizationName: ADAPT PROGRAMS, LLC
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Mailing Information
Address1: PO BOX 474
Address2:  
City: ANGLETON
State: TX
PostalCode: 775160474
CountryCode: US
TelephoneNumber: 8326217581
FaxNumber: 2813775870
Practice Location
Address1: 1523 NORMAL PARK DR
Address2: SUITE C
City: HUNTSVILLE
State: TX
PostalCode: 773404297
CountryCode: US
TelephoneNumber: 8326217581
FaxNumber: 2813775870
Other Information
ProviderEnumerationDate: 01/19/2017
LastUpdateDate: 10/13/2017
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: GARDZINA
AuthorizedOfficialFirstName: JOSEPH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8326217581
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: DIRECTOR
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR0405X  Y Ambulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder

No ID Information.


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