NIRVANA DRUG & ALCOHOL TREATMENT INSTITUTE (NPI# 1942286240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942286240 |
| Entity Type | Organization |
| Organization Name | NIRVANA DRUG & ALCOHOL TREATMENT INSTITUTE |
| Practice Address |
948 11th St Suite 23 Modesto CA 95354-2308 |
| Mailing Address |
Po Box 3264 Modesto CA 95353-3264 |
| Practice Telephone | 2095791151 |
| Practice Fax Number | 2095799605 |
| Mailing Telephone | 2095791151 |
| Mailing Fax Number | 2095799605 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-07-08 |
| Authorized Official Name | MR. DANE THOMAS HELDING (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2095791151 |
| Authorized Official Credential | CAS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
S00009CN | CA | Ambulatory Health Care Facilities |
| X | 324500000X | Substance Abuse Rehabilitation Facility | S00009CN | CA | Residential Treatment Facilities |
| Street Address |
948 11TH ST SUITE 23 |
| City | MODESTO |
| State | CA |
| Zip Code | 95354-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598789026 | Kenneth William Davis | Marriage & Family Therapist | 948 11th St, Suite 11 H, Modesto, CA 95354-2308 | 2006-07-27 |
| 1760686307 | Kimberly Grace | Counselor | 948 11th St, Suite 20, Modesto, CA 95354-2308 | 2007-06-14 |
| 1770616088 | Stanislaus County | Community/Behavioral Health | 948 11th St, Modesto, CA 95354-2308 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669987301 | Tristan Renee Bowman | Student in an Organized Health Care Education/Training Program | 1700 Mchenry Way, Modesto, CA 95354 | 2017-12-04 |
| 1134647944 | Melissa Kathleen Huizar | Occupational Therapist | 730 17th Street, Modesto, CA 95354 | 2017-08-31 |
| 1861948424 | Daniel Jones | Specialist/Technologist | 224 Eula Drive, Modesto, CA 95354 | 2016-09-01 |
| 1710333976 | Elite First Health | Clinic/Center | 3121 Yosemite Blvd Ste D2, Modesto, CA 95354 | 2016-05-06 |
| 1790169084 | Ronika Rodriguez | Licensed Vocational Nurse | 328 Thrasher Ave, Modesto, CA 95354 | 2015-07-16 |
| 1942688528 | Progressive Home Health and Hospice Care, LLC | Home Infusion | 1619 H Street, Modesto, CA 95354 | 2015-05-14 |
| 1225434277 | Ashley Ann Brown | Case Manager/Care Coordinator | 1000 Needham, Modesto, CA 95354 | 2014-11-18 |
| 1922380518 | Thao Truong | Specialist | 1321 I St Ste #3, Modesto, CA 95354 | 2011-09-09 |
| 1437441938 | Amy Marie Lipomi | Counselor | 613 13th Street, Suite B, Modesto, CA 95354 | 2011-05-03 |
| 1871800813 | Patricia Ashley Dalman | Social Worker | 1321 I Street Suite 3, Modesto, CA 95354 | 2010-09-13 |
| Find all providers in zip 95354 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1710373808 | Addiction Free Recovery Services | Clinic/Center | 2937 Veneman Ave Ste A105, Modesto, CA 95356-0639 | 2015-04-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.