Healthcare Provider Details

I. General information

NPI: 1619332251
Provider Name (Legal Business Name): COUNTY OF RIVERISDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N STATE ST
HEMET CA
92543-2960
US

IV. Provider business mailing address

4095 COUNTY CIRCLE DR
RIVERSIDE CA
92503-3410
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-1625
  • Fax:
Mailing address:
  • Phone: 951-358-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW CHANG
Title or Position: DIRECTOR RUHS - BEHAVIORAL HEALTH
Credential:
Phone: 951-358-4500