Healthcare Provider Details

I. General information

NPI: 1881254084
Provider Name (Legal Business Name): KERN BEHAVORIAL HEALTH AND RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 COLUMBUS ST
BAKERSFIELD CA
93306-2719
US

IV. Provider business mailing address

3715 COLUMBUS ST
BAKERSFIELD CA
93306-2719
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-7168
  • Fax:
Mailing address:
  • Phone: 661-868-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: UNKNOWN UNKNOWN
Title or Position: UNKNOWN
Credential:
Phone: 661-868-7168