Basic Information
| Provider Information | |||||||||
| NPI: | 1477884260 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ANKA BEHAVIORAL HEALTH, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ANKA AKRON VETERANS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1850 GATEWAY BLVD | ||||||||
| Address2: | STE 900 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945203279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258254700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3258 RINGLE RD | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487019519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896918420 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2010 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| AuthorizedOfficialLastName: | VYROSTEK | ||||||||
| AuthorizedOfficialFirstName: | GINA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR QUALITY MANAGEMENT MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9258254700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.