Provider Demographics
NPI:1821117672
Name:ALTERNATIVE ACTION PROGRAM
Entity Type:Organization
Organization Name:ALTERNATIVE ACTION PROGRAM
Other - Org Name:DMG AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MILLI
Authorized Official - Middle Name:ATLEE
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:805-988-1112
Mailing Address - Street 1:2575 WAGON WHEEL RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1165
Mailing Address - Country:US
Mailing Address - Phone:805-988-1112
Mailing Address - Fax:805-988-4883
Practice Address - Street 1:2575 WAGON WHEEL RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1165
Practice Address - Country:US
Practice Address - Phone:805-988-1112
Practice Address - Fax:805-988-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01862101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01862OtherADDICTION SERVICES