Provider Demographics
NPI:1932930120
Name:CALIFORNIA HEALING HORIZONS
Entity type:Organization
Organization Name:CALIFORNIA HEALING HORIZONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:INA
Authorized Official - Middle Name:
Authorized Official - Last Name:CREEKBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-856-5904
Mailing Address - Street 1:967 KENDALL DR STE A-515
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-4306
Mailing Address - Country:US
Mailing Address - Phone:909-856-5904
Mailing Address - Fax:
Practice Address - Street 1:1650 SPRUCE ST STE 240
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-7403
Practice Address - Country:US
Practice Address - Phone:909-856-5904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ILLUMINATING PSYCHOLOGICAL SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center