Provider Demographics
NPI:1689258188
Name:ALLIANT INTERNATIONAL UNIVERSITY, INC.
Entity Type:Organization
Organization Name:ALLIANT INTERNATIONAL UNIVERSITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SILADI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:619-376-0512
Mailing Address - Street 1:10065 OLD GROVE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1664
Mailing Address - Country:US
Mailing Address - Phone:619-376-0512
Mailing Address - Fax:
Practice Address - Street 1:10065 OLD GROVE RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1664
Practice Address - Country:US
Practice Address - Phone:858-547-9803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)