Provider Demographics
NPI:1184939274
Name:PORTIA BELL HUME BEHAVIORAL HEALTH AND TRAINING CENTER
Entity type:Organization
Organization Name:PORTIA BELL HUME BEHAVIORAL HEALTH AND TRAINING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHELPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-825-1793
Mailing Address - Street 1:3340 WALNUT AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3340 WALNUT AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2215
Practice Address - Country:US
Practice Address - Phone:510-745-9151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service