NPIMap

Organization Active NPI

Nirvana Drug and Alcohol

  • Substance Abuse Rehabilitation Facility
  • Modesto, CA
National Provider Identifier
1215204276
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
NIRVANA DRUG AND ALCOHOL
Practice address
1100 Kansas Ave Ste BC&D
Modesto, CA 95351-1596
Phone
(209) 579-1151
Fax
(209) 579-9605
NPI assigned
Nov 18, 2011
Organization subpart
Yes
Parent organization
NIRVANA DRUG AND ALCOHOL INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dane T Helding
Title
Executive Director
Phone
(209) 579-1151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1100 Kansas Ave Ste BC&D
Modesto, CA 95351-1596

Mailing address

1100 Kansas Ave
Suite B
Modesto, CA 95351-1596
Phone (209) 579-1151

Other identifiers 1

IdentifierTypeStateIssuer
500009CNOtherCADEPARTMENT OF HEALTH CARE SERVICES

National Provider Directory

National Provider Directory
Tax ID family
Nirvana Drug and Alcohol Institute3 organizations share this tax ID, including this one
Part of
Nirvana Drug and Alcohol Institute

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1100 Kansas Ave
Ste Bcd
Modesto, CA 95351
Phone (209) 579-1151

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1215204276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 KANSAS AVE",
            "address_2": "SUITE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511596",
            "telephone_number": "209-579-1151",
            "fax_number": "209-579-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 KANSAS AVE STE BC&D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511596",
            "telephone_number": "209-579-1151",
            "fax_number": "209-579-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIRVANA DRUG AND ALCOHOL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NIRVANA DRUG AND ALCOHOL INSTITUTE",
        "enumeration_date": "2011-11-18",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "HELDING",
        "authorized_official_first_name": "DANE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-579-1151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH CARE SERVICES",
            "identifier": "500009CN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.