Healthcare Provider Details

I. General information

NPI: 1477884260
Provider Name (Legal Business Name): ANKA BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3258 RINGLE RD
AKRON MI
48701-9519
US

IV. Provider business mailing address

1850 GATEWAY BLVD STE 900
CONCORD CA
94520-3279
US

V. Phone/Fax

Practice location:
  • Phone: 989-691-8420
  • Fax:
Mailing address:
  • Phone: 925-825-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GINA M VYROSTEK
Title or Position: SENIOR QUALITY MANAGEMENT MANAGER
Credential:
Phone: 925-825-4700