# NATIONAL COUNCILON ALCOHOLISM AND DRUG DEPENDENCE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962975789
- **Authorized official:** ALLAN EZEQUIEL FLORES (COUNSELOR)
- **Authorized official phone:** (818) 997-0414

## Contact information

- **Practice address:** 6166 VESPER AVE, VAN NUYS, CA 91411-2851
- **Practice address phone:** (818) 997-0414
- **Practice address fax:** (818) 997-0851
- **Mailing address:** 6166 VESPER AVE, VAN NUYS, CA 91411-2851
- **Mailing address phone:** (818) 997-0414
- **Mailing address fax:** (818) 997-0851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2019
- **Last updated:** 01/03/2019