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General NPI Number Information
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NPI Number | 1518233097
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Entity Type | Organization
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Legal Business Name | NCI AFFILIATES, INCORPORATED
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 496 LINNE RD
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City | PASO ROBLES
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State | CA
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Zip | 93446-7470
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Country | US
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Telephone | 805-238-6630
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Fax | 805-239-9073
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Provider Business Mailing Address
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Address Line | 496 LINNE RD
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City | PASO ROBLES
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State | CA
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Zip | 93446-7470
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Country | US
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Telephone | 805-238-6630
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Fax | 805-239-9073
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CRYSTAL NEVOSH
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Credential | M.S.
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Telephone | 805-238-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | CA
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