Provider Demographics
NPI:1255517959
Name:ADOLESCENT SUBSTANCE ABUSE PROGRAMS, INC.
Entity type:Organization
Organization Name:ADOLESCENT SUBSTANCE ABUSE PROGRAMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZER
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:513-792-1272
Mailing Address - Street 1:9403 KENWOOD RD # C-212
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6895
Mailing Address - Country:US
Mailing Address - Phone:513-792-1272
Mailing Address - Fax:513-891-4449
Practice Address - Street 1:9403 KENWOOD RD # C-212
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6895
Practice Address - Country:US
Practice Address - Phone:513-792-1272
Practice Address - Fax:513-891-4449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health