Organization
RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC
Active
Other names
Morongo Indian Health
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM THOMSEN (CEO)
(909) 864-1097
Entity
Organization
Contact information
Practice address
11555 1/2 POTRERO RD, BANNING, CA 92220-6946
(951) 849-4761
(951) 849-5612
Mailing address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 864-1097
(909) 744-3960
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC03854F
—
CA
Enumeration date
01/18/2007
Last updated
08/25/2021
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