Healthcare Provider Details

I. General information

NPI: 1467168757
Provider Name (Legal Business Name): INLAND EMPIRE MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 E SOUTHERN AVE
TEMPE AZ
85282-5212
US

IV. Provider business mailing address

412 E SOUTHERN AVE
TEMPE AZ
85282-5212
US

V. Phone/Fax

Practice location:
  • Phone: 480-797-4600
  • Fax: 480-800-2212
Mailing address:
  • Phone: 651-800-5900
  • Fax: 480-800-2212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CALEB REID
Title or Position: CEO
Credential: DNP, APRN, PMHNP-BC
Phone: 651-800-5900