1720204696 NPI number — HUMANISTIC ALTERNATIVES TO ADDICTION RESEARCH AND TREATMENT, INC.

Table of content: (NPI 1720204696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720204696 NPI number — HUMANISTIC ALTERNATIVES TO ADDICTION RESEARCH AND TREATMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUMANISTIC ALTERNATIVES TO ADDICTION RESEARCH AND TREATMENT, 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:
H.A.A.R.T.
Provider Other Organization Name Type Code:
5
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:
1720204696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10850 MACARTHUR BLVD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94605-5266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-875-2300
Provider Business Mailing Address Fax Number:
510-875-2310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10850 MACARTHUR BLVD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94605-5266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-875-2300
Provider Business Practice Location Address Fax Number:
510-875-2310
Provider Enumeration Date:
04/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BURCH
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
510-875-2300

Provider Taxonomy Codes

  • Taxonomy code: 261QM2800X , with the licence number:  01-70 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0167 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".