San Manuel Indian Health
LBN: Riverside-San Bernardino County Indian Health, Inc.
San Manuel Indian Health is an health care organization with primary practice located at 11980 Mount Vernon Ave , Grand Terrace CA 92313-5172. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty.
Riverside-San Bernardino County Indian Health, Inc. can be contacted via phone (909) 864-1097, or through Thomsen, William via phone (909) 864-1097.
Contact Information
Primary practice address
11980 Mount Vernon Ave
Grand Terrace CA 92313-5172
Phone: (909) 864-1097
Fax: (909) 744-3960
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | 240000751 | California |
Profile Details
| NPI number | 1174676670 |
|---|---|
| LBN Legal business name | Riverside-San Bernardino County Indian Health, Inc. |
| DBA Doing business as | San Manuel Indian Health |
| Authorized official | Thomsen, William |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Aug 25th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174676670 | NPPES |
| California | MEDICAID | FHC03869F |
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