Provider Demographics
NPI:1760012330
Name:BEHAVIORAL EMOTIONAL & ACADEMIC MENTORING (BEAM), LLC
Entity Type:Organization
Organization Name:BEHAVIORAL EMOTIONAL & ACADEMIC MENTORING (BEAM), LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:LEP, EDS, MA
Authorized Official - Phone:714-307-7213
Mailing Address - Street 1:13104 PHILADELPHIA ST STE 218
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-6315
Mailing Address - Country:US
Mailing Address - Phone:714-307-7213
Mailing Address - Fax:
Practice Address - Street 1:13104 PHILADELPHIA ST STE 218
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-6315
Practice Address - Country:US
Practice Address - Phone:714-307-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)