NIRVANA DRUG AND ALCOHOL TREATMENT INSTITUTE NPI 1639539661

NPI Information

NPI: 1639539661
Provider Name: NIRVANA DRUG AND ALCOHOL TREATMENT INSTITUTE
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1116 ALICE ST
MODESTO, CA
ZIP 95350
Phone: (209) 578-3132
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NIRVANA DRUG AND ALCOHOL TREATMENT INSTITUTE is a substance abuse rehabilitation facility in Modesto, 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. NIRVANA DRUG AND ALCOHOL TREATMENT INSTITUTE NPI is 1639539661. The provider is registered as an organization entity type.

The provider's business location address is:

1116 ALICE ST
MODESTO, CA
ZIP 95350-905
Phone: (209) 578-3132
Fax: (209) 578-3498

The provider's authorized official is Michael Edward Bagley .
The authorized official title is Cfo and has the following contact phone number (209) 579-1151.

The enumeration date for this NPI number is 3/3/2016 and was last updated on 3/3/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		500009GN	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500009GN	OTHER	CALIFORNIA	DEPARTMENT OF HEALTH CARE SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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