Basic Information
| Provider Information | |||||||||
| NPI: | 1982960720 | ||||||||
| 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: | 8324573540 | ||||||||
| FaxNumber: | 2813775870 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 W 1ST STREET | ||||||||
| Address2: | SUITE B ROOM 1 | ||||||||
| City: | FREEPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8324573540 | ||||||||
| FaxNumber: | 2813775870 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2012 | ||||||||
| LastUpdateDate: | 10/13/2017 | ||||||||
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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 | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.