MEDICARE: BETTER DECISIONS COUNSELING RIVERSIDE

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
1	251B00000X	Case Management Agency
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1902287741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER DECISIONS COUNSELING RIVERSIDE

Provider Business Mailing Address
First Line	:	3865 BROCKTON AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92501-3201
Country	:	US
Telephone Number	:	909-731-8667
Fax Number	:

Provider Business Practice Location Address
First Line	:	3865 BROCKTON AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92501-3201
Country	:	US
Telephone Number	:	909-731-8667
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JENNIFER MARQUECHO
Credential	:	RADT I
Telephone Number	:	909-731-8667

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	11/28/2016

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