Provider Demographics
NPI:1851524946
Name:ARROWHEAD REGIONAL MEDICAL CENTER-BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ARROWHEAD REGIONAL MEDICAL CENTER-BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISCHARGE COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALONZO
Authorized Official - Last Name:DODGE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MSED
Authorized Official - Phone:909-580-2814
Mailing Address - Street 1:400 N PEPPER AVE
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1801
Mailing Address - Country:US
Mailing Address - Phone:909-580-2814
Mailing Address - Fax:909-580-2500
Practice Address - Street 1:400 N PEPPER AVE
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1801
Practice Address - Country:US
Practice Address - Phone:909-580-1800
Practice Address - Fax:909-580-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit