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Contact Information

INNOVATE BEHAVIORAL HEALTH MEDICAL GROUP INC
732 N MOUNTAIN AVE STE A
UPLAND, CA91786-4372
 Phone: 909-579-2555
 Fax: 909-579-2118
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Marriage & Family Therapist

106H00000X
 

Mental Health

101YM0800X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for INNOVATE BEHAVIORAL HEALTH MEDICAL GROUP INC

NPI Number 1972129948
LBN Legal business name INNOVATE BEHAVIORAL HEALTH MEDICAL GROUP INC
Authorized official HENRY KHIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/24/2020
Last updated 02/17/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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