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NPI Code Detail

MEDICARE: ALPINE SPECIAL TREATMENT CENTER

MEDICARE: ALPINE SPECIAL TREATMENT CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility02099008CA

General Provider Information

NPI Number : 1518151976
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPINE SPECIAL TREATMENT CENTER
Provider Business Mailing Address
First Line : 2120 ALPINE BLVD
Second Line :
City : ALPINE
State : CA
Zip : 91901-2113
Country : US
Telephone Number : 619-445-7570
Fax Number : 619-659-3122
Provider Business Practice Location Address
First Line : 2120 ALPINE BLVD
Second Line :
City : ALPINE
State : CA
Zip : 91901-2113
Country : US
Telephone Number : 619-445-7570
Fax Number : 619-659-3122
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. KRISTIN ALLRED
Credential :
Telephone Number : 619-445-7570
Provider Enumeration Date : 08/29/2007
Last Update Date : 08/29/2007

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Directions to “ALPINE SPECIAL TREATMENT CENTER ” Practice Location

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