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General NPI Number Information
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NPI Number | 1609173251
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Entity Type | Organization
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Legal Business Name | ALPINE SPECIAL TREATMENT CENTER
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 02/17/2011
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Provider Practice Location Address
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Address Line | 2120 ALPINE BLVD
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City | ALPINE
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State | CA
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Zip | 91901-2113
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Country | US
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Telephone | 619-722-1426
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 ALPINE BLVD
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City | ALPINE
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State | CA
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Zip | 91901-2113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | KRISTIN STEELE
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Credential |
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Telephone | 619-722-7253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 02113008
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License Number State | CA
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