MEDICARE: MCALISTER INSTITUTE FOR TREATMENT AND EDUCATION

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	370045ADN	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37-8542	OTHER	CA	MEDICAL PROVIDER NUMBER

General Provider Information

NPI Number	:	1891916292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCALISTER INSTITUTE FOR TREATMENT AND EDUCATION

Provider Business Mailing Address
First Line	:	1400 N JOHNSON AVE
Second Line	:	SUITE 101
City	:	EL CAJON
State	:	CA
Zip	:	92020-1650
Country	:	US
Telephone Number	:	619-442-0277
Fax Number	:

Provider Business Practice Location Address
First Line	:	2429 FENTON ST
Second Line	:	SUITE A
City	:	CHULA VISTA
State	:	CA
Zip	:	91914-3517
Country	:	US
Telephone Number	:	619-482-9300
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JEANNE MCALISTER
Credential	:
Telephone Number	:	619-442-0277

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	09/18/2014

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