| Organization Name: | FAMILY SERVICE AGENCY OF SAN BERNARDINO |
| NPI Number: | 1275739492 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTINE LAURA EDGCOMBE (PRESIDENT CEO) |
| Mailing Address: | 23406 Crest Forest Drive Crestline |
| State: | CA US |
| Postal Code: | 92325 |
| Phone Number: | 9093384689 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2007 |
| NPI Last Update Date: | 12/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | 0244138 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |