| Supportive Services | |
|
900 E Gilbert St Ste 4 San Bernardino CA 92415-0936 | |
| (909) 387-7406 | |
| (909) 421-9392 |
| Full Name | Supportive Services |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 900 E Gilbert St Ste 4, San Bernardino, California |
| Authorized Official Name and Position | Erica Ochoa (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 9093880879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Services 303 E Vanderbilt Way San Bernardino CA 92415-0001 Ph: (909) 388-0801 | Supportive Services 900 E Gilbert St Ste 4 San Bernardino CA 92415-0936 Ph: (909) 387-7406 |
| NPI Number | 1306055603 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 06/15/2022 |
| Certification Date | 05/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306055603 | NPI | - | NPPES |
| 360008668 | Other | CA | MEDICAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | ZZZ74743Z (California) | Primary |
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