Provider Demographics
NPI:1932304185
Name:BI-BETT
Entity Type:Organization
Organization Name:BI-BETT
Other - Org Name:EAST OAKLAND RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-568-2432
Mailing Address - Street 1:10700 MACARTHUR BLVD
Mailing Address - Street 2:12
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5298
Mailing Address - Country:US
Mailing Address - Phone:510-568-2432
Mailing Address - Fax:510-568-3912
Practice Address - Street 1:10700 MACARTHUR BLVD
Practice Address - Street 2:12
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5298
Practice Address - Country:US
Practice Address - Phone:510-568-2432
Practice Address - Fax:510-568-3912
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIBETT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-18
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS0504101918251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01ADOtherALCOHOL AND DRUGS