Healthcare Provider Details

I. General information

NPI: 1558804351
Provider Name (Legal Business Name): BHC ALHAMBA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 EAST CAMINO REAL AVE
ARCADIA CA
91006
US

IV. Provider business mailing address

4619 N. ROSEMEAD BLVD
ROSEMEAD CA
91770
US

V. Phone/Fax

Practice location:
  • Phone: 626-286-1191
  • Fax:
Mailing address:
  • Phone: 626-286-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number550003674
License Number StateCA

VIII. Authorized Official

Name: BRETT GRAVES
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential:
Phone: 626-286-1191