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NPI Code Detail

MEDICARE: RIVERSIDE RECOVERY RESOURCES

MEDICARE: RIVERSIDE RECOVERY RESOURCES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13245S0500XChildren's Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1366710881
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERSIDE RECOVERY RESOURCES
Provider Business Mailing Address
First Line : PO BOX 549
Second Line :
City : LAKE ELSINORE
State : CA
Zip : 92531-0549
Country : US
Telephone Number : 951-216-7300
Fax Number : 951-674-5227
Provider Business Practice Location Address
First Line : 1119 W 7TH ST
Second Line :
City : SAN JACINTO
State : CA
Zip : 92582-3856
Country : US
Telephone Number : 951-216-7300
Fax Number : 951-674-5227
Authorized Official
Title or Position : CEO
Name : BERNARD L TRUAX II
Credential :
Telephone Number : 951-216-7300
Provider Enumeration Date : 12/12/2011
Last Update Date : 12/12/2011

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Directions to “RIVERSIDE RECOVERY RESOURCES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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