Provider Demographics
NPI:1326258609
Name:THE CLINEBELL INSTITUTE
Entity Type:Organization
Organization Name:THE CLINEBELL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYUNGSIG
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:909-447-6331
Mailing Address - Street 1:1325 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3154
Mailing Address - Country:US
Mailing Address - Phone:909-447-6331
Mailing Address - Fax:909-447-6267
Practice Address - Street 1:211 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2708
Practice Address - Country:US
Practice Address - Phone:909-447-6329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherMENTAL HEALTH CARE PROVID