Healthcare Provider Details

I. General information

NPI: 1689049314
Provider Name (Legal Business Name): MFI RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4295 BROCKTON AVE
RIVERSIDE CA
92501-3446
US

IV. Provider business mailing address

5870 ARLINGTON AVE
RIVERSIDE CA
92504-2037
US

V. Phone/Fax

Practice location:
  • Phone: 951-683-6596
  • Fax: 951-683-4239
Mailing address:
  • Phone: 951-683-6569
  • Fax: 991-351-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number330013GN
License Number StateCA

VIII. Authorized Official

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