NIRVANA DRUG AND ALCOHOL INSTITUTE (NPI# 1811200439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811200439 |
| Entity Type | Organization |
| Organization Name | NIRVANA DRUG AND ALCOHOL INSTITUTE |
| Practice Address |
1028 Reno Ave Modesto CA 95351-1127 |
| Mailing Address |
1100 Kansas Ave Suite B Modesto CA 95351-1596 |
| Practice Telephone | 2095791103 |
| Practice Fax Number | 2095781085 |
| Mailing Telephone | 2095791151 |
| Mailing Fax Number | 2095799605 |
| Enumeration Date | 2010-07-24 |
| Last Update Date | 2012-05-25 |
| Authorized Official Name | MR. DANE HELDING (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2095791151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 50009EN | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS | 500009EN | 01 |
| Street Address |
1028 RENO AVE |
| City | MODESTO |
| State | CA |
| Zip Code | 95351-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396868295 | Michael Edward Bagley | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2007-04-08 |
| 1306302963 | Elizabeth Tillman | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2019-02-19 |
| 1205392859 | Jerry Farmer | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2019-02-19 |
| 1164988721 | Jessie James Lawrence | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2019-02-19 |
| 1649736208 | David Rivera | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2019-02-19 |
| 1225593841 | Cleveland Crowley | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2019-02-07 |
| 1528523545 | Robert Chapman | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2019-02-04 |
| 1053882183 | Robert Carl Thompson | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2018-12-16 |
| 1528286580 | David Glen Kirkland | Counselor | 1028 Reno Ave, Modesto, CA 95351-1127 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392487 | Western Dental Services, Inc. | Dentist | 1524 Richland Ave, Ceres, CA 95351 | 2017-12-18 |
| 1881039873 | Sabrina Arora-thissen | Family Medicine | 401 Paradise Rd. Ste, Modesto, CA 95351 | 2013-05-03 |
| 1407163561 | Maliza Cahee Oliver | Dentist | 1404 Mitchell Rd, Modesto, CA 95351 | 2010-09-09 |
| 1124345616 | Jason Lee Paul Wayrynen | Social Worker | 1219 N Carpenter Rd Ste 12, Modesto, CA 95351 | 2010-04-23 |
| 1841469640 | Edgar Hse-hwa Han | Physical Medicine & Rehabilitation | 1521 N. Carpenter Road, Suite D-1, Modesto, CA 95351 | 2008-02-26 |
| 1326259326 | Karen Ann Peterson | Nurse Practitioner | 1340 Mitchell Rd, Modesto, CA 95351 | 2007-05-24 |
| 1013139054 | Bounchanh Trysavath | Physician Assistant | 300 I St, Modesto, CA 95351 | 2007-05-02 |
| 1245363464 | Sharon Basaldua1 | Counselor | 813 Moon Lane, Modesto, CA 95351 | 2007-03-14 |
| 1710046834 | Phil Chen | Dentist | 1460 Mitchell Road, Suite B, Modesto, CA 95351 | 2006-12-06 |
| 1649366055 | Victor Y. Chen | Family Medicine | 401 Paradise Road, Suite E, Modesto, CA 95351 | 2006-10-04 |
| Find all providers in zip 95351 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215204276 | Nirvana Drug and Alcohol | Substance Abuse Rehabilitation Facility | 1100 Kansas Ave Ste Bc&d, Modesto, CA 95351-1596 | 2011-11-18 |
| 1417252032 | Adolescence's Last Resort | Substance Abuse Rehabilitation Facility | 218 E. Orangeburg Avenue, Modesto, CA 95350 | 2011-01-12 |
| 1225279888 | Elan Senior Living, Inc. | Substance Abuse Rehabilitation Facility | 412 Corson Ave, Modesto, CA 95350-5408 | 2009-03-11 |
| 1083765366 | Elan Senior Living Dba The Living Center | Substance Abuse Rehabilitation Facility | 416 Corson Ave, Modesto, CA 95350-5408 | 2007-01-15 |
| 1528174737 | Recovery Systems-new Hope Recovery | Substance Abuse Rehabilitation Facility | 220 Standiford Ave Ste F, Modesto, CA 95350-1159 | 2006-08-21 |
| 1104372176 | Valley Recovery Resources | Substance Abuse Rehabilitation Facility | 1405 11th St, Modesto, CA 95354-0748 | 2016-08-30 |
| 1639539661 | Nirvana Drug and Alcohol Treatment Institute | Substance Abuse Rehabilitation Facility | 1116 Alice St, Modesto, CA 95350-5905 | 2016-03-03 |
| 1124483540 | Recovery Systems | Substance Abuse Rehabilitation Facility | 220 Standiford Ave, Suite F, Modesto, CA 95350-1159 | 2015-12-30 |
| 1477709467 | Insight Solutions | Substance Abuse Rehabilitation Facility | 1400 Florida Ave, Suite 107, Modesto, CA 95350-4422 | 2008-08-11 |
| 1477741528 | Elan Senior Living | Substance Abuse Rehabilitation Facility | 1717 Coffee Rd, Suite A, Modesto, CA 95355-2808 | 2007-10-12 |
| Find all providers in MODESTO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.