ALTA MIRA RECOVERY PROGRAMS NPI 1669764908

NPI Information

ALTA MIRA RECOVERY PROGRAMS is a substance abuse rehabilitation facility in Sausalito, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. ALTA MIRA RECOVERY PROGRAMS NPI is 1669764908. The provider is registered as an organization entity type.

The provider's business location address is:

125 BULKLEY AVE
SAUSALITO, CA
ZIP 94965-231
Phone: (415) 332-1350

The provider's authorized official is Wesley Stephenson .
The authorized official title is Vice President Of Finance and has the following contact phone number (619) 820-0034.

The CLIA number assigned to this NPI record is 05D2051870 - other - resid aod program/detox with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2011 and was last updated on 5/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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