Provider Demographics
NPI:1710101084
Name:ANKA BEHAVIORAL HEALTH INCORPORATED
Entity Type:Organization
Organization Name:ANKA BEHAVIORAL HEALTH INCORPORATED
Other - Org Name:BRIGHT HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF QUALITY MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-825-4700
Mailing Address - Street 1:3480 BUSKIRK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4343
Mailing Address - Country:US
Mailing Address - Phone:925-825-4700
Mailing Address - Fax:925-825-0816
Practice Address - Street 1:8210 S BRIGHT RD
Practice Address - Street 2:
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231
Practice Address - Country:US
Practice Address - Phone:209-982-1235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CA397001381320600000X, 320800000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children