Provider Demographics
NPI:1043522543
Name:CHINO VALLEY UNIFIED SCHOOL DISTRICT BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:CHINO VALLEY UNIFIED SCHOOL DISTRICT BEHAVIORAL HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORM
Authorized Official - Middle Name:
Authorized Official - Last Name:ENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:909-628-1201
Mailing Address - Street 1:5130 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4130
Mailing Address - Country:US
Mailing Address - Phone:909-628-1201
Mailing Address - Fax:
Practice Address - Street 1:12970 3RD ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3464
Practice Address - Country:US
Practice Address - Phone:909-628-1201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health