Organization
COUNTY OF SAN BERNARDINO
Active
Other names
DAAS Age Wise
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK EDWARD THOMAS LMFT (MENTAL HEALTH CLINIC SUPERVISOR)
(951) 662-3730
Entity
Organization
Contact information
Practice address
686 E MILL ST, SAN BERNARDINO, CA 92408-1610
(909) 798-8455
(909) 798-8582
Mailing address
686 E MILL ST, SAN BERNARDINO, CA 92415-0647
(909) 798-8573
(909) 798-8582
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/19/2019
Last updated
05/09/2022
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