Legacy Alliance Outreach
Peer Specialist in Modesto, CA. Organization (NPI-2).
NPI number1619708229
StatusActive
Last updated in NPPESAug 13, 2024
Details
- NPI
- 1619708229
- Entity type
- Organization (NPI-2)
- Legal business name
- Legacy Alliance Outreach
- Organization subpart
- No
- Enumeration date
- Aug 13, 2024
- Certification date
- Aug 13, 2024
- Last updated
- Aug 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
820 H StModesto, CA 95354-3419
Phone 209-480-6199
Mailing address
2601 Oakdale Rd Ste 154Modesto, CA 95355-2256
Phone 209-480-6199
Authorized official
Alexander Bequette
Program Director
9257840386
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