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AT PROVIDER GROUP OF CALIFORNIA PC NPI 1700580305


NPI Information

NPI: 1700580305
Provider Name: AT PROVIDER GROUP OF CALIFORNIA PC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 17D2301357

Address:
3550 WATT AVE STE 140
SACRAMENTO, CA
ZIP 95821
Phone: (845) 769-8758
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AT PROVIDER GROUP OF CALIFORNIA PC is a rehabilitation and substance use disorder clinic center in Sacramento, CA. AT PROVIDER GROUP OF CALIFORNIA PC NPI is 1700580305. The provider is registered as an organization entity type.

The provider's business location address is:

3550 WATT AVE STE 140
SACRAMENTO, CA
ZIP 95821-666
Phone: (845) 769-8758

The provider's authorized official is Renee Mullings .
The authorized official title is Director Of Compliance and has the following contact phone number (951) 691-9101.

The CLIA number assigned to this NPI record is 17D2301357 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2023 and was last updated on 3/28/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthNo
2324500000XSubstance Abuse Rehabilitation FacilityNo
3261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.