Healthcare Provider Details

I. General information

NPI: 1578823647
Provider Name (Legal Business Name): INLAND BEHAVIORAL AND HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 E. RAMSEY STEET
BANNING CA
92220-0998
US

IV. Provider business mailing address

1963 N E ST
SAN BERNARDINO CA
92405-3919
US

V. Phone/Fax

Practice location:
  • Phone: 951-846-2560
  • Fax: 951-849-2310
Mailing address:
  • Phone: 909-881-6146
  • Fax: 909-881-3479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DR. TEMETRY A. LINDSEY
Title or Position: CEO/PRESIDENT
Credential:
Phone: 909-708-8158