NPIMap

Organization Active NPI

Riverside Recovery Resources

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wildomar, CA
National Provider Identifier
1003138512
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
RIVERSIDE RECOVERY RESOURCES
Practice address
21800 Caynon Drive
Wildomar, CA 92595-9181
Phone
(951) 674-5354
Fax
(951) 674-5227
NPI assigned
Feb 25, 2010
Last updated
Feb 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Derrick Bruce Harvey, CAS IINPI 1942326434
Title
Executive Directore
Phone
(951) 674-5354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X CA Primary

Addresses

Primary practice location

21800 Caynon Drive
Wildomar, CA 92595-9181

Mailing address

PO Box 549
Lake Elsinore, CA 92531-0549
Phone (951) 674-5354

National Provider Directory

National Provider Directory
Tax ID family
Riverside Recovery Resources Inc45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1003138512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925310549",
            "telephone_number": "951-674-5354",
            "fax_number": "951-674-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 CAYNON DRIVE",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959181",
            "telephone_number": "951-674-5354",
            "fax_number": "951-674-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RECOVERY RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-25",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTORE",
        "authorized_official_telephone_number": "951-674-5354",
        "authorized_official_credential": "CAS II"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.