Provider Demographics
NPI:1386852366
Name:ALI BABA CORPORATION
Entity Type:Organization
Organization Name:ALI BABA CORPORATION
Other - Org Name:RIVIERA EVP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTELARO
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:408-347-3103
Mailing Address - Street 1:PO BOX 2C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95109-0003
Mailing Address - Country:US
Mailing Address - Phone:408-288-7734
Mailing Address - Fax:408-288-7831
Practice Address - Street 1:101 JOSE FIGUERES AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2022
Practice Address - Country:US
Practice Address - Phone:408-347-3120
Practice Address - Fax:408-347-3121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD0773068OtherCA CORP #
CA24595183OtherEDD #