Organization
ALI BABA CORPORATION
Active
Other names
Riviera EVP
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE MONTELARO MPA (BILLING MANAGER)
(408) 347-3103
Entity
Organization
Contact information
Practice address
101 JOSE FIGUERES AVE, SAN JOSE, CA 95116-2022
(408) 347-3120
(408) 347-3121
Mailing address
PO BOX 2C, SAN JOSE, CA 95109-0003
(408) 288-7734
(408) 288-7831
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24595183
EDD #
CA
01
—
D0773068
CA CORP #
CA
Enumeration date
05/21/2007
Last updated
07/21/2022
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