Antioch Substance Abuse Programs

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

ANTIOCH SUBSTANCE ABUSE PROGRAMS

Practice address

3838 N West Ave
Fresno, CA 93705-2703

Phone

(559) 307-3482

Fax

(559) 294-0303

NPI assigned

Nov 16, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prof. Jerome Ester JacksonNPI 1518292796

Title

President

Phone

(559) 307-3482

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerome Ester Jackson, PHD

  • Pastoral Counselor
  • Fresno, CA
  • NPI 1518292796
  NPD (past) Authorized official
• Alstelma Toliver Jackson

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
  • NPI 1407181688
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1649507484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937052703",
            "telephone_number": "559-307-3482",
            "fax_number": "559-294-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937052703",
            "telephone_number": "559-307-3482",
            "fax_number": "559-294-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIOCH SUBSTANCE ABUSE PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "ESTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-307-3482",
        "authorized_official_name_prefix": "Prof."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Austin Jeffery Antiporda
• Shakoyia S Antoine
• Gary T Antone, M.P.T., A.T.C.
• Michael Antonino, COTA/L

• Substance Use Disorder Rehabilitation Clinic/Center in Fresno, CA
• Providers in Fresno, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.