Provider Demographics
NPI:1972626380
Name:ENKI HEALTH & RESEARCH SYSTEMS, INC.
Entity Type:Organization
Organization Name:ENKI HEALTH & RESEARCH SYSTEMS, INC.
Other - Org Name:ALPINE COUNTY BEHAVIORAL HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT-C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:URMER
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:818-973-4899
Mailing Address - Street 1:150 E OLIVE AVE
Mailing Address - Street 2:STE. 203
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1846
Mailing Address - Country:US
Mailing Address - Phone:818-973-4899
Mailing Address - Fax:818-973-4888
Practice Address - Street 1:75C DIAMOND VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:MARKLEEVILLE
Practice Address - State:CA
Practice Address - Zip Code:96120
Practice Address - Country:US
Practice Address - Phone:530-694-1816
Practice Address - Fax:530-694-2387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000000215Medicaid
CA000000215Medicaid