1538683677 NPI number — BH THERAPY CORP.

Table of content: (NPI 1538683677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538683677 NPI number — BH THERAPY CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BH THERAPY CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538683677
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2174
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90213-2174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-279-2878
Provider Business Mailing Address Fax Number:
310-570-2249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8665 WILSHIRE BLVD STE 407
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90211-2933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-279-2878
Provider Business Practice Location Address Fax Number:
310-570-2249
Provider Enumeration Date:
07/31/2017

Additional Information

Authorized Official

Authorized Official Last Name:
TOOMARI
Authorized Official First Name:
SHAHDOKHT
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
310-279-2878

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY23664 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1922367929 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1538683677 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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