MEDICARE: COUNTY OF RIVERSIDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00033	OTHER	CA	LEGAL ENTITY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447261540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF RIVERSIDE

Provider Business Mailing Address
First Line	:	PO BOX 7549
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92513-7549
Country	:	US
Telephone Number	:	951-358-4501
Fax Number	:	951-358-6905

Provider Business Practice Location Address
First Line	:	4095 COUNTY CIRCLE DR
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-3410
Country	:	US
Telephone Number	:	951-358-4501
Fax Number	:	951-358-6905

Authorized Official
Title or Position	:	DIRECTOR OF RUHS-BEHAVIORAL HEALTH
Name	:	DR. MATTHEW CHANG
Credential	:
Telephone Number	:	951-358-4501

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	09/03/2024

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Directions to “COUNTY OF RIVERSIDE ” Practice Location

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