Provider Demographics
NPI:1275305112
Name:ALTER MENTAL HEALTH - DANA POINT LLC
Entity Type:Organization
Organization Name:ALTER MENTAL HEALTH - DANA POINT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUENSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-877-2419
Mailing Address - Street 1:34270 PACIFIC COAST HWY STE C
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2847
Mailing Address - Country:US
Mailing Address - Phone:949-877-2419
Mailing Address - Fax:949-308-7789
Practice Address - Street 1:33522 AVENIDA CALITA
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-4902
Practice Address - Country:US
Practice Address - Phone:949-886-5833
Practice Address - Fax:949-308-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMHBS230474OtherDEPARTMENT OF HEALTH CARE SERVICES
CA306006362OtherDEPARTMENT OF SOCIAL SERVICES