BH-TC Opco LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

BH-TC OPCO LLC

Doing business as

Jackson House Tulare

Practice address

1168 Leland Ave
Tulare, CA 93274-7811

Phone

(619) 507-6385

NPI assigned

Oct 19, 2022

Last updated

Oct 19, 2022By 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

Chief Development Officer

Phone

(858) 254-2510

Specialties & licenses 1

Addresses

Other names 1

• Jackson House Tulare 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": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1447977582",
    "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": "1168 LELAND AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932747811",
            "telephone_number": "619-507-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BH-TC OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "ENGBRECHT",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CHIEF DEVELOPMENT OFFICER",
        "authorized_official_telephone_number": "858-254-2510"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson House Tulare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andres Benincore Robledo, MD
• Breanna Alicia Berg, PHARMD
• Vanessa Bermudez
• Joseph Ryan Bertao, AMFT
• Abraham N Betre, MD, INC
• Angela R Bibbs
• Erik Bidinger-Boggess, LCSW LICENSE#64039
• Zara Beceril Bilal
• Ashley Marie Bird, MSW-INTERN
• Jade Bisconer

• Mental Illness Community Based Residential Treatment Facility in Tulare, CA
• Providers in Tulare, 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 Oct 19, 2022; 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.