Provider Demographics
NPI:1235781808
Name:BHC ALHAMBRA HOSPITAL, INC.
Entity Type:Organization
Organization Name:BHC ALHAMBRA HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-286-1191
Mailing Address - Street 1:4619 N. ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770
Mailing Address - Country:US
Mailing Address - Phone:626-286-1191
Mailing Address - Fax:626-287-7391
Practice Address - Street 1:1925 LOMBARDY ROAD
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108
Practice Address - Country:US
Practice Address - Phone:626-460-8507
Practice Address - Fax:626-287-7391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHC ALHAMBRA HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSM34032GMedicaid