Organization
INNERCEPT
Active
Parent organization
ALTIORHEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALTIORHEALTHCARE
Authorized official
MR. JONATHAN MARK MONROE MD (CFO)
(951) 334-2233
Entity
Organization
Contact information
Practice address
1115 IRONWOOD DRIVE, SUITE A, COEUR D ALENE, ID 83814-4936
(208) 665-7178
(208) 765-6972
Mailing address
12424 WILSHIRE BLVD SUITE 800, LOS ANGELES, CA 90025
(310) 457-6302
(310) 457-6318
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/10/2008
Last updated
05/26/2023
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