Healthcare Provider Details

I. General information

NPI: 1851220461
Provider Name (Legal Business Name): RIVERSIDE SEASON GROVE CLHF INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19700 SEASON GROVE DR
RIVERSIDE CA
92507-1565
US

IV. Provider business mailing address

19700 SEASON GROVE DR
RIVERSIDE CA
92507-1565
US

V. Phone/Fax

Practice location:
  • Phone: 805-404-3934
  • Fax:
Mailing address:
  • Phone: 805-404-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: EVA FE SOSNOVSKY
Title or Position: OWNER
Credential:
Phone: 805-404-3934