BH-Ic Opco, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

BH-IC OPCO, LLC

Doing business as

Jackson House El Centro

Practice address

2364 South 2ND Street
El Centro, CA 92243-9653

Phone

(858) 254-2510

NPI assigned

Apr 8, 2019

Last updated

Apr 8, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chad Engbrecht

Title

Vice President

Phone

(858) 254-2510

Specialties & licenses 1

Addresses

Other names 1

• Jackson House El Centro Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1104389204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 PARKWAY DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 SOUTH 2ND STREET",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439653",
            "telephone_number": "858-254-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BH-IC OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "ENGBRECHT",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "858-254-2510"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson House El Centro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jose Bernal
• Yolanda Bernal
• Michael K Berry, M.D.
• Best S.T.E.P. Forward
• Kerry Bevins
• Rakesh Kumar Bhansali, MD
• Seema Bhansali
• Farah M Bharambeygui Borbon
• Jocelyn Pamela Bibiano
• Yovana Karina Bibiano

• Mental Illness Community Based Residential Treatment Facility in El Centro, CA
• Providers in El Centro, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.