Organization
RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
Active
Other names
Morongo Indian Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LINWOOD J. KILLAM (CEO)
(951) 849-4761
Entity
Organization
Contact information
Practice address
11555 POTRERO RD, BANNING, CA 92220-6946
(951) 849-4761
(951) 849-5612
Mailing address
11555 POTRERO RD, BANNING, CA 92220-6946
(951) 849-4761
(951) 849-5612
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EAPC03854F
—
CA
Enumeration date
04/19/2007
Last updated
08/22/2020
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