Provider Demographics
NPI:1336771047
Name:COMMUNITY BEHAVIOR HEALTH II
Entity Type:Organization
Organization Name:COMMUNITY BEHAVIOR HEALTH II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-277-1547
Mailing Address - Street 1:11897 BENHAM RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1326
Mailing Address - Country:US
Mailing Address - Phone:314-277-1547
Mailing Address - Fax:
Practice Address - Street 1:11897 BENHAM RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1326
Practice Address - Country:US
Practice Address - Phone:314-277-1547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)