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Organization

ARMC CSU

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ERICA PORTEOUS (CHIEF COMPLIANCE OFFICER)
(909) 388-0882
Entity
Organization

Contact information

Practice address
400 N. PEPPER AVE, COLTON, CA 92324
(909) 382-3080
(909) 382-3105
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0026
(909) 388-0801
(909) 890-0435

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
ZZZ74743Z
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3600036DE
MEDICAL PROVIDER NUMBER
CA
Enumeration date
06/08/2007
Last updated
06/18/2019
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