Provider Demographics
NPI:1235433145
Name:SPECIALTY BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:SPECIALTY BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-752-3520
Mailing Address - Street 1:3262 HOLIDAY CT
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-0026
Mailing Address - Country:US
Mailing Address - Phone:858-752-3520
Mailing Address - Fax:858-452-6700
Practice Address - Street 1:3262 HOLIDAY CT
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0026
Practice Address - Country:US
Practice Address - Phone:858-752-3520
Practice Address - Fax:858-452-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18893103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty