Organization
FCMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVORRIE TOMLINSON (CLINIC COORDINATOR)
(909) 798-4400
Entity
Organization
Contact information
Practice address
1175 IDAHO ST STE 102, REDLANDS, CA 92374-4591
(909) 798-4400
Mailing address
1175 IDAHO ST STE 102, REDLANDS, CA 92374-4591
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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