Healthcare Provider Details

I. General information

NPI: 1235781808
Provider Name (Legal Business Name): BHC ALHAMBRA HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 LOMBARDY ROAD
SAN MARINO CA
91108
US

IV. Provider business mailing address

4619 N. ROSEMEAD BLVD
ROSEMEAD CA
91770
US

V. Phone/Fax

Practice location:
  • Phone: 626-460-8507
  • Fax: 626-287-7391
Mailing address:
  • Phone: 626-286-1191
  • Fax: 626-287-7391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PEGGY MINNICK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: R.N.
Phone: 626-286-1191