Organization
WESELPA DBH
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
1800 E 7TH ST, ONTARIO, CA 91764-1210
(909) 382-3080
(909) 382-3105
Mailing address
268 WEST 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
—
3600036BH
MEDICAL PROVIDER NUMBER
CA
Enumeration date
06/22/2007
Last updated
07/13/2007
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