Provider Demographics
NPI:1043086713
Name:BHRS
Entity Type:Organization
Organization Name:BHRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICE TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNICO
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MAGANA
Authorized Official - Suffix:
Authorized Official - Credentials:RADT
Authorized Official - Phone:209-247-0735
Mailing Address - Street 1:1904 RICHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-4562
Mailing Address - Country:US
Mailing Address - Phone:209-525-7411
Mailing Address - Fax:
Practice Address - Street 1:1904 RICHLAND AVE
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-4562
Practice Address - Country:US
Practice Address - Phone:209-525-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty