NPIMap

Organization Active NPI

Nirvana Drug and Alcohol Institute

  • Substance Abuse Rehabilitation Facility
  • Modesto, CA
National Provider Identifier
1811200439
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
50009EN Issued in CA
Legal business name
NIRVANA DRUG AND ALCOHOL INSTITUTE
Practice address
1028 Reno Ave
Modesto, CA 95351-1127
Phone
(209) 579-1103
Fax
(209) 578-1085
NPI assigned
Jul 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 50009EN CA Primary

Addresses

Primary practice location

1028 Reno Ave
Modesto, CA 95351-1127

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
500009ENOtherCADEPARTMENT OF ALCOHOL AND DRUG PROGRAMS

National Provider Directory

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

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 B
Modesto, CA 95351
Phone (209) 558-8884

1028 Reno Ave
Modesto, CA 95351
Phone (209) 579-1103

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1279929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1811200439",
    "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": "1028 RENO AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511127",
            "telephone_number": "209-579-1103",
            "fax_number": "209-578-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIRVANA DRUG AND ALCOHOL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-24",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "HELDING",
        "authorized_official_first_name": "DANE",
        "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": "CA",
            "license": "50009EN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS",
            "identifier": "500009EN",
            "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 25, 2012; 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.