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General NPI Number Information
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NPI Number | 1972159986
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Entity Type | Organization
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Legal Business Name | THE ALLIANCE FOR COMMUNITY WELLNESS
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 875 GEER RD
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City | TURLOCK
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State | CA
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Zip | 95380-3311
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Country | US
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Telephone | 209-633-3057
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Fax | 209-633-3031
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Provider Business Mailing Address
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Address Line | 875 GEER RD
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City | TURLOCK
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State | CA
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Zip | 95380-3311
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Country | US
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Telephone | 209-633-3057
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Fax | 209-633-3031
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | DAVID XIONG
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Credential |
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Telephone | 916-533-3428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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