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General NPI Number Information
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NPI Number | 1245627587
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Entity Type | Organization
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Legal Business Name | ALLIANT INTERNATIONAL UNIVERSITY
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 335 CALMACE DR
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City | DIXON
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State | CA
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Zip | 95620-2317
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Country | US
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Telephone | 707-639-0037
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Fax |
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Provider Business Mailing Address
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Address Line | 335 CALMACE DR
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City | DIXON
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State | CA
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Zip | 95620-2317
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Country | US
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Telephone | 707-639-0037
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Fax |
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Authorized Official
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Title or Position | ADDICTION COUNSELER
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Name | LOURDES YADIRA MEJIA
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Credential |
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Telephone | 707-639-0037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | D9411566
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License Number State | CA
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