Organization
COUNTY OF SAN BERNARDINO
Active
Parent organization
DEPARTMENT OF BEHAVIORAL HEALTH
Other names
Mariposa Community Counseling
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENT OF BEHAVIORAL HEALTH
Authorized official
ERICA OCHOA (CHIEF COMPLIANCE OFFICER)
(909) 388-0882
Entity
Organization
Contact information
Practice address
2940 INLAND EMPIRE BLVD, ONTARIO, CA 91764-4898
(909) 458-1350
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0026
(909) 388-0801
(909) 890-0435
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
ZZZ74743Z
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360003699
ADP MEDICAL PROVIDER NUMB
CA
Enumeration date
05/18/2007
Last updated
09/07/2022
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