Healthcare Provider Details
I. General information
NPI: 1861690216
Provider Name (Legal Business Name): COUNTY OF RIVERSIDE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2007
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3499 10TH ST
RIVERSIDE CA
92501-3617
US
IV. Provider business mailing address
PO BOX 7659
RIVERSIDE CA
92513
US
V. Phone/Fax
- Phone: 951-328-2281
- Fax:
- Phone: 951-358-6900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/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