Provider Demographics
NPI:1124669536
Name:ENVIRONMENTAL ALTERNATIVES
Entity type:Organization
Organization Name:ENVIRONMENTAL ALTERNATIVES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-283-3330
Mailing Address - Street 1:PO BOX 3940
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-3940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:530-231-0265
Practice Address - Street 1:630 BETTY BELLE LN
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8702
Practice Address - Country:US
Practice Address - Phone:530-283-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENVIRONMENTAL ALTERNATIVES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-07
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children