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NPI Code Detail

MEDICARE: IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES

MEDICARE: IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1265650279
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 202 N 8TH ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2302
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 HACIENDA DR STE C
Second Line :
City : CALEXICO
State : CA
Zip : 92231-1889
Country : US
Telephone Number : 442-265-1525
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : ANDREA KUHLEN
Credential :
Telephone Number : 760-482-4112
Provider Enumeration Date : 04/23/2007
Last Update Date : 12/09/2019

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Directions to “IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES ” Practice Location

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