Provider Demographics
NPI:1033761358
Name:LUMINA ALLIANCE
Entity Type:Organization
Organization Name:LUMINA ALLIANCE
Other - Org Name:WOMEN'S SHELTER PROGRAM OF SAN LUIS OBISPO DBA STAND STRONG
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BORGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-720-3312
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-0125
Mailing Address - Country:US
Mailing Address - Phone:805-781-6401
Mailing Address - Fax:
Practice Address - Street 1:51 ZACA LN STE 150
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7319
Practice Address - Country:US
Practice Address - Phone:805-781-6401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)