Provider Demographics
NPI:1942603162
Name:INSTITUTE FOR BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:INSTITUTE FOR BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:JEBELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-289-1041
Mailing Address - Street 1:201 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6831
Mailing Address - Country:US
Mailing Address - Phone:909-289-1041
Mailing Address - Fax:909-363-3021
Practice Address - Street 1:201 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6831
Practice Address - Country:US
Practice Address - Phone:909-289-1041
Practice Address - Fax:909-363-3021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty