Healthcare Provider Details

I. General information

NPI: 1962708602
Provider Name (Legal Business Name): RIVERSIDE COUNTY DEPT OF MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 ATLANTA AVE SUITE D3
RIVERSIDE CA
92507-7419
US

IV. Provider business mailing address

1827 ATLANTA AVE SUITE D 3
RIVERSIDE CA
92507-7419
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-8000
  • Fax: 951-955-8010
Mailing address:
  • Phone: 951-955-8000
  • Fax: 951-955-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. PEDRO ARCINIEGA
Title or Position: PEER SUPPORT SPECIALIST
Credential:
Phone: 951-955-8000