Basic Information
Provider Information
NPI: 1609199348
EntityType: 2
ReplacementNPI:  
OrganizationName: ADAPT PROGRAMS, LLC
LastName:  
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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: 20514 HIGHWAY 6
Address2: SUITE A
City: MANVEL
State: TX
PostalCode: 775783810
CountryCode: US
TelephoneNumber: 8324573540
FaxNumber: 2813775870
Other Information
ProviderEnumerationDate: 03/09/2010
LastUpdateDate: 10/17/2017
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: GARDZINA
AuthorizedOfficialFirstName: JOSEPH
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AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 9794803327
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: LCDC,SAP
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR0405X7657TXY Ambulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder

No ID Information.


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