Healthcare Provider Details

I. General information

NPI: 1215854336
Provider Name (Legal Business Name): ALIBI HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E 21ST ST # 302
BAKERSFIELD CA
93305-5117
US

IV. Provider business mailing address

4208 ROSEDALE HWY STE 302
BAKERSFIELD CA
93308-6173
US

V. Phone/Fax

Practice location:
  • Phone: 916-716-3508
  • Fax:
Mailing address:
  • Phone: 916-716-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MIKA RICE
Title or Position: CEO
Credential:
Phone: 916-716-3508