# INLAND COUNTIES REGIONAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134322159
- **Authorized official:** MARY LYNN CLARK (DIRECTOR)
- **Authorized official phone:** (909) 890-3400

## Contact information

- **Practice address:** 674 E BRIER DR, SAN BERNARDINO, CA 92408-2800
- **Practice address phone:** (909) 890-3000
- **Practice address fax:** (909) 890-3001
- **Mailing address:** PO BOX 6127, SAN BERNARDINO, CA 92412-6127
- **Mailing address phone:** (909) 890-3000
- **Mailing address fax:** (909) 890-3001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | CA | Yes |

## Other

- **Enumeration date:** 06/07/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GPT001490 | — | CA |
| 05 | — | GRR000010 | — | CA |
| 05 | — | GRRCT00010 | — | CA |
| 05 | — | GRRP00010 | — | CA |