Provider Demographics
NPI:1942482104
Name:INLAND BEHAVIORAL AND HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:INLAND BEHAVIORAL AND HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:909-708-8166
Mailing Address - Street 1:665 N D ST STE H
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1109
Mailing Address - Country:US
Mailing Address - Phone:909-708-8166
Mailing Address - Fax:
Practice Address - Street 1:665 N D ST STE H
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1109
Practice Address - Country:US
Practice Address - Phone:909-708-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY466483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy