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General NPI Number Information
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NPI Number | 1851864060
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Entity Type | Organization
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Legal Business Name | RIVERSIDE LATINO COMMISSION ON ALCOHOL & DRUG ABUSE SERVICES, INC.
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 91275 66TH AVENUE SUITE 100
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City | MECCA
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State | CA
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Zip | 92254
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Country | US
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Telephone | 760-863-7860
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Fax | 760-398-9790
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Provider Business Mailing Address
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Address Line | 1612 1ST ST
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City | COACHELLA
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State | CA
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Zip | 92236-1407
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Country | US
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Telephone | 760-398-9000
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Fax | 760-398-9790
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARIBEL TAPIA
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Credential |
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Telephone | 760-398-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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