Healthcare Provider Details

I. General information

NPI: 1386852366
Provider Name (Legal Business Name): ALI BABA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 JOSE FIGUERES AVE
SAN JOSE CA
95116-2022
US

IV. Provider business mailing address

PO BOX 2C
SAN JOSE CA
95109-0003
US

V. Phone/Fax

Practice location:
  • Phone: 408-347-3120
  • Fax: 408-347-3121
Mailing address:
  • Phone: 408-288-7734
  • Fax: 408-288-7831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: CHRISTINE MONTELARO
Title or Position: BILLING MANAGER
Credential: MPA
Phone: 408-347-3103