Provider Demographics
NPI:1801192679
Name:GOPEC BEHAVIORAL CENTER
Entity Type:Organization
Organization Name:GOPEC BEHAVIORAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GODFREY
Authorized Official - Middle Name:UZO
Authorized Official - Last Name:NWOGENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-889-0300
Mailing Address - Street 1:363 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1128
Mailing Address - Country:US
Mailing Address - Phone:909-889-0300
Mailing Address - Fax:909-889-0307
Practice Address - Street 1:363 W 6TH ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1128
Practice Address - Country:US
Practice Address - Phone:909-889-0300
Practice Address - Fax:909-889-0307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health