Provider Demographics
NPI:1497474795
Name:BTC HEG, INC
Entity Type:Organization
Organization Name:BTC HEG, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UTILIZATION LEAD
Authorized Official - Prefix:
Authorized Official - First Name:ARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-991-1766
Mailing Address - Street 1:4505 LAS VIRGENES RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1956
Mailing Address - Country:US
Mailing Address - Phone:855-414-8100
Mailing Address - Fax:
Practice Address - Street 1:1360 E SPRUCE AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3378
Practice Address - Country:US
Practice Address - Phone:855-414-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BTC HEG, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No283Q00000XHospitalsPsychiatric Hospital