Provider Demographics
NPI:1114127388
Name:BI-BETT
Entity Type:Organization
Organization Name:BI-BETT
Other - Org Name:SHAMIA RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:CINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:RAS
Authorized Official - Phone:925-798-7250
Mailing Address - Street 1:3018 WILLOW PASS RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2598
Mailing Address - Country:US
Mailing Address - Phone:925-798-7250
Mailing Address - Fax:925-798-3359
Practice Address - Street 1:126 OHIO ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5049
Practice Address - Country:US
Practice Address - Phone:707-644-2577
Practice Address - Fax:707-644-5501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIBETT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480002CN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility