Healthcare Provider Details

I. General information

NPI: 1306202866
Provider Name (Legal Business Name): MFI RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 UNIVERSITY AVEUE
RIVERSIDE CA
92501-3199
US

IV. Provider business mailing address

5870 ARLINGTON AVENUE SUITE 103
RIVERSIDE CA
92504
US

V. Phone/Fax

Practice location:
  • Phone: 951-683-6596
  • Fax: 951-683-4239
Mailing address:
  • Phone: 951-683-6596
  • Fax: 991-351-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number330013KN
License Number StateCA

VIII. Authorized Official

Name: MRS. JOSSYE KARIN COOK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 951-683-6596