Organization
BPT PHASE2 LLC
Active
Organization
BPT PHASE2 LLC
Active
Other names
Mile High Mental Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
PERCY IRVING (PRESIDENT & COO)
(510) 385-4456
Entity
Organization
Contact information
Practice address
3674 N RANCHO DR, SUITE 101, LAS VEGAS, NV 89130-3110
(702) 396-2988
(510) 281-6883
Mailing address
1034 10TH ST, OAKLAND, CA 94607-2720
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/05/2011
Last updated
09/05/2011
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