Provider Demographics
NPI:1871628750
Name:DEPARTMENT OF BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:DEPARTMENT OF BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER II
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:760-256-5026
Mailing Address - Street 1:805 E MOUNTAIN VIEW ST
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-3033
Mailing Address - Country:US
Mailing Address - Phone:760-256-5026
Mailing Address - Fax:760-256-5092
Practice Address - Street 1:805 E MOUNTAIN VIEW ST
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-3033
Practice Address - Country:US
Practice Address - Phone:760-256-5026
Practice Address - Fax:760-256-5092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization