Organization
COUNTY OF SAN BERNARDINO
Active
Parent organization
DEPARTMENT OF BEHAVIORAL HEALTH
Other names
Centralized Child Intensive Case Mgmt Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENT OF BEHAVIORAL HEALTH
Authorized official
MS. ERICA OCHOA (CHIEF COMPLIANCE OFFICER)
(909) 388-0882
Entity
Organization
Contact information
Practice address
658 E BRIER DR STE 200, SAN BERNARDINO, CA 92408-2847
(909) 501-0700
(909) 381-2330
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0026
(909) 388-0801
(909) 890-0435
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360003681
MEDICAL PROVIDER NUMBER
CA
Enumeration date
06/19/2007
Last updated
06/16/2022
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