Organization
CHILDREN'S CRISIS RESPONSE TEAM MORONGO BASIN
Active
Parent organization
DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY, CA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY, CA
Authorized official
MR. MICHAEL J DAY (INFORMATION TECHNOLOGY MANAGER)
(909) 388-0570
Entity
Organization
Contact information
Practice address
56357 PIMA TRAIL, YUCCA VALLEY, CA 92284
(909) 382-3080
(909) 382-3105
Mailing address
268 W. HOSPITALITY LANE, SUITE 400, SAN BERNARDINO, CA 92415-0026
(909) 382-3080
(909) 382-3105
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
ZZZ74743Z
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3600036DG
MEDICAL PROVIDER NUMBER
CA
Enumeration date
05/29/2007
Last updated
07/13/2007
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