Provider Demographics
NPI:1649475831
Name:BI-BETT
Entity type:Organization
Organization Name:BI-BETT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:CATC
Authorized Official - Phone:925-458-1978
Mailing Address - Street 1:510 WOLLAM AVE
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4364
Mailing Address - Country:US
Mailing Address - Phone:925-458-1978
Mailing Address - Fax:925-458-8996
Practice Address - Street 1:510 WOLLAM AVE
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-4364
Practice Address - Country:US
Practice Address - Phone:925-458-1978
Practice Address - Fax:925-458-8996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070001SN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility