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1505 W Highland Ave Ste 19 San Bernardino CA 92411-1215 | |
(909) 880-0600 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 1505 W Highland Ave Ste 19, San Bernardino, California |
Authorized Official Name and Position | Joyce Forest (CLINICAL Q. A. OFFICER SOCIAL WKER) |
Authorized Official Contact | 9098800600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1505 W Highland Ave Ste 19 San Bernardino CA 92411-1215 Ph: (909) 880-0600 | 1505 W Highland Ave Ste 19 San Bernardino CA 92411-1215 Ph: (909) 880-0600 |
NPI Number | 1053512970 |
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Provider Enumeration Date | 05/29/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1053512970 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | 18119386 (California) | Primary |
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