Organization
NIRVANA DRUG AND ALCOHOL
Active
Parent organization
NIRVANA DRUG AND ALCOHOL INSTITUTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
NIRVANA DRUG AND ALCOHOL INSTITUTE
Authorized official
MR. DANE T HELDING (EXECUTIVE DIRECTOR)
(209) 579-1151
Entity
Organization
Contact information
Practice address
1100 KANSAS AVE STE BC&D, MODESTO, CA 95351-1596
(209) 579-1151
(209) 579-9605
Mailing address
1100 KANSAS AVE, SUITE B, MODESTO, CA 95351-1596
(209) 579-1151
(209) 579-9605
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500009CN
DEPARTMENT OF HEALTH CARE SERVICES
CA
Enumeration date
11/18/2011
Last updated
05/28/2019
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