Provider Demographics
NPI:1033605720
Name:SAFE ALTERNATIVES TO VIOLENT ENVIRONMENTS
Entity Type:Organization
Organization Name:SAFE ALTERNATIVES TO VIOLENT ENVIRONMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-574-2250
Mailing Address - Street 1:1900 MOWRY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1722
Mailing Address - Country:US
Mailing Address - Phone:510-574-2250
Mailing Address - Fax:
Practice Address - Street 1:1900 MOWRY AVE STE 201
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1722
Practice Address - Country:US
Practice Address - Phone:510-574-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)