Provider Demographics
NPI:1518091966
Name:SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS
Entity Type:Organization
Organization Name:SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS
Other - Org Name:DESERT MOUNTAIN CHILDREN'S CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LLAMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-552-6700
Mailing Address - Street 1:17800 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1221
Mailing Address - Country:US
Mailing Address - Phone:760-552-6700
Mailing Address - Fax:760-946-0819
Practice Address - Street 1:17800 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1221
Practice Address - Country:US
Practice Address - Phone:760-552-6700
Practice Address - Fax:760-946-0819
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-16
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS3610363251300000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)