Provider Demographics
NPI:1619197761
Name:SAN BERNARDINO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:SAN BERNARDINO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
Other - Org Name:CENTRAL VALLEY REINTEGRATION
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-382-3133
Mailing Address - Street 1:780 E GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-1003
Mailing Address - Country:US
Mailing Address - Phone:909-387-7793
Mailing Address - Fax:909-387-7386
Practice Address - Street 1:780 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-1003
Practice Address - Country:US
Practice Address - Phone:909-387-7793
Practice Address - Fax:909-387-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health