Provider Demographics
NPI:1467168757
Name:INLAND EMPIRE MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:INLAND EMPIRE MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:651-800-5991
Mailing Address - Street 1:412 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5212
Mailing Address - Country:US
Mailing Address - Phone:651-800-5991
Mailing Address - Fax:480-800-2212
Practice Address - Street 1:410 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5212
Practice Address - Country:US
Practice Address - Phone:480-797-4646
Practice Address - Fax:480-800-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness