Amethyst Behavioral Health, LLC

Key facts

NPI

1134714033

Entity type

Organization (NPI type 2)

Primary specialty

Clinical Social Worker 1041C0700X

Legal business name

AMETHYST BEHAVIORAL HEALTH, LLC

Practice address

921 Tribune St
Redlands, CA 92374-3422

Phone

(909) 809-7671

NPI assigned

Mar 3, 2021

Organization subpart

No

Authorized official

Name

Cole Oliver Fry

Title

Ceo

Phone

(909) 809-7671

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Amethyst Behavioral Health, LLC Clinical Social Worker · Redlands, CA · NPI 1740113299
  NPPES parent name

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Amethyst Behavioral Health, LLC Clinical Social Worker · Redlands, CA · NPI 1740113299
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary M Entezar Marriage & Family Therapist · Redlands, CA · NPI 1225297195
  NPD

National Provider Directory

Tax ID family

Amethyst Behavioral Health LLC (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

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All providers in Redlands, CA · Clinical Social Worker in California