Healthcare Provider Details

I. General information

NPI: 1114154010
Provider Name (Legal Business Name): COUNTY OF RIVERSIDE MENTAL HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10182 INDIANA AVE
RIVERSIDE CA
92503-5304
US

IV. Provider business mailing address

232 1/4 S SADLER AVE
LOS ANGELES CA
90022-2377
US

V. Phone/Fax

Practice location:
  • Phone: 951-509-2400
  • Fax:
Mailing address:
  • Phone: 626-848-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA PITTMAN-WILLIAMS
Title or Position: HUMAN RESOURCES CLERK-C
Credential:
Phone: 951-358-4608