Inland Behavioral and Health Services, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

INLAND BEHAVIORAL AND HEALTH SERVICES, INC.

Doing business as

Banning Family Community Health Center

Practice address

1070 E. Ramsey Steet
Banning, CA 92220-0998

Phone

(951) 846-2560

Fax

(951) 849-2310

NPI assigned

May 23, 2012

Last updated

Jul 19, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

INLAND BEHAVIORAL AND HEALTH SERVICES, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Temetry A. Lindsey

Title

Ceo/President

Phone

(909) 708-8158

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Banning Family Community Health Center Doing business as
• Inland Behavioral and Health Services, Inc. Other name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578823647. Details of each certification follow.

• CCN 751037 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 751037

Legal name

INLAND BEHAVIORAL AND HEALTH SERVICES INC

Doing business as

BANNING FAMILY COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 22, 2014

Last certification

Jan 22, 2014

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 4, 1978 in CA

Enrollment address

1070 East Ramsey Street
Banning, CA 92220-0998

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Inland Behavioral and Health Services, Inc.

  dba Inland Family Community Health Center

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1275562969

  2769392927

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Inland Behavioral and Health Services, Inc.

  dba Inland Family Community Health Center

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1275562969

  O20150421002236

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Inland Behavioral Servi

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500422400000",
    "number": "1578823647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 N E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053919",
            "telephone_number": "909-881-6146",
            "fax_number": "909-881-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 E. RAMSEY STEET",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922200998",
            "telephone_number": "951-846-2560",
            "fax_number": "951-849-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND BEHAVIORAL AND HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INLAND BEHAVIORAL AND HEALTH SERVICES, INC.",
        "enumeration_date": "2012-05-23",
        "last_updated": "2017-07-19",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "TEMETRY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "909-708-8158",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC 70520F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banning Family Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Inland Behavioral and Health Services, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katelyn Temple Hutchinson Arellano, LPT
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• Nancy Sharinne Ibarra
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• Inland Behavioral and Health Services, Inc.
• Amy Lynn Inman, MD
• Michelle Denise Jackson, LPT
• Judine Jacobs, RNP MSN
• Susan Lee Jacobs, LCSW

• Federally Qualified Health Center (FQHC) in Banning, CA
• Providers in Banning, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.