| Centralized Child Intensive Case Mgmt Services | |
|
658 E Brier Dr Ste 200 San Bernardino CA 92408-2847 | |
| (909) 501-0700 | |
| (909) 381-2330 |
| Full Name | Centralized Child Intensive Case Mgmt Services |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 658 E Brier Dr Ste 200, San Bernardino, California |
| Authorized Official Name and Position | Erica Ochoa (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 9093880882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centralized Child Intensive Case Mgmt Services 303 E Vanderbilt Way San Bernardino CA 92415-0026 Ph: (909) 388-0801 | Centralized Child Intensive Case Mgmt Services 658 E Brier Dr Ste 200 San Bernardino CA 92408-2847 Ph: (909) 501-0700 |
| NPI Number | 1043415037 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 06/16/2022 |
| Certification Date | 06/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043415037 | NPI | - | NPPES |
| 360003681 | Other | CA | MEDICAL PROVIDER NUMBER |
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