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NPI Code Detail

MEDICARE: ALPHA PROJECT FOR THE HOMELESS

MEDICARE: ALPHA PROJECT FOR THE HOMELESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility370073ANCA

General Provider Information

NPI Number : 1932612264
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA PROJECT FOR THE HOMELESS
Provider Business Mailing Address
First Line : 993 POSTAL WAY
Second Line :
City : VISTA
State : CA
Zip : 92083-6945
Country : US
Telephone Number : 760-403-8112
Fax Number :
Provider Business Practice Location Address
First Line : 975 POSTAL WAY
Second Line :
City : VISTA
State : CA
Zip : 92083-6945
Country : US
Telephone Number : 760-630-9922
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : JASON RODRIGUEZ
Credential :
Telephone Number : 760-630-9922
Provider Enumeration Date : 11/08/2017
Last Update Date : 11/08/2017

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Directions to “ALPHA PROJECT FOR THE HOMELESS ” Practice Location

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