Provider Demographics
NPI:1760658157
Name:ALTA'S ICF INC.
Entity Type:Organization
Organization Name:ALTA'S ICF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-752-6679
Mailing Address - Street 1:7820 FRUITRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6743
Mailing Address - Country:US
Mailing Address - Phone:916-381-7594
Mailing Address - Fax:916-381-2138
Practice Address - Street 1:7820 FRUITRIDGE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6743
Practice Address - Country:US
Practice Address - Phone:916-381-7594
Practice Address - Fax:916-381-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities