Provider Demographics
NPI:1669699526
Name:IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLANCARTE-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MPA
Authorized Official - Phone:442-265-1500
Mailing Address - Street 1:202 NORTH EIGHTH STREET
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243
Mailing Address - Country:US
Mailing Address - Phone:760-482-4000
Mailing Address - Fax:
Practice Address - Street 1:120 NORTH EIGHTH STREET
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243
Practice Address - Country:US
Practice Address - Phone:760-482-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-19
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW1228Medicare PIN