Provider Demographics
NPI:1053850602
Name:BI-BETT
Entity Type:Organization
Organization Name:BI-BETT
Other - Org Name:EAST COUNTY WOLLAM
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:CINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-798-7250
Mailing Address - Street 1:PO BOX 5487
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94524-0487
Mailing Address - Country:US
Mailing Address - Phone:925-798-7250
Mailing Address - Fax:925-798-3359
Practice Address - Street 1:34 DAVI AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-3701
Practice Address - Country:US
Practice Address - Phone:925-427-1384
Practice Address - Fax:925-427-4217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070001VN3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA070001VNOtherCALIFORNIA DHCS LICENSE