NPIMap

Organization Active NPI

Riverside Recovery Resources

  • Adolescent and Children Mental Health Clinic/Center
  • Moreno Valley, CA
National Provider Identifier
1265698443
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
330009PN Issued in CA
Legal business name
RIVERSIDE RECOVERY RESOURCES
Practice address
24975 Bay Ave
Moreno Valley, CA 92553-3801
Phone
(951) 674-5354
Fax
(951) 674-5227
NPI assigned
Aug 6, 2008
Last updated
Aug 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Mr. Derrick Bruce Harvey, CRPM CASIINPI 1942326434
Title
Executive Director
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
Adolescent and Children Mental Health Clinic/Center 261QM0855X 330009PN CA Primary

Addresses

Primary practice location

24975 Bay Ave
Moreno Valley, CA 92553-3801

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 Resources45 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": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1265698443",
    "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": "951-674-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24975 BAY AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533801",
            "telephone_number": "951-674-5354",
            "fax_number": "951-674-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RECOVERY RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "951-674-5354",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRPM CASII"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": "330009PN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.