Organization
ALTERA VITA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLI KING (CHIEF OPERATING OFFICER)
(520) 400-1708
Entity
Organization
Contact information
Practice address
7632 E FAIR MEADOWS LOOP, TUCSON, AZ 85756-6151
(520) 400-1708
Mailing address
7632 E FAIR MEADOWS LOOP, TUCSON, AZ 85756-6151
(520) 400-1708
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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