1104512672 NPI number — ALANA HOLLAND THERAPY INC

Table of content: (NPI 1104512672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104512672 NPI number — ALANA HOLLAND THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALANA HOLLAND THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104512672
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3507 MARENGO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91001-4043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-676-8500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 E LEMON
Provider Second Line Business Practice Location Address:
#34
Provider Business Practice Location Address City Name:
MONROVIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91016-9101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-808-4093
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HOLLAND
Authorized Official First Name:
ALANA
Authorized Official Middle Name:
ADRIANA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
626-676-8500

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)