Provider Demographics
NPI:1831214741
Name:ANKA BEHAVIORAL HEALTH INCORPORATED
Entity type:Organization
Organization Name:ANKA BEHAVIORAL HEALTH INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF QUALITY MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-825-4700
Mailing Address - Street 1:3480 BUSKIRK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4343
Mailing Address - Country:US
Mailing Address - Phone:925-825-4700
Mailing Address - Fax:925-825-2610
Practice Address - Street 1:1959/67 SOLANO WAY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-676-9768
Practice Address - Fax:925-676-9837
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANKA BEHAVIORAL HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-20
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA071441023251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health