Riverside County Dept Mental Health

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

HO502091228 Issued in CA

Legal business name

RIVERSIDE COUNTY DEPT MENTAL HEALTH

Practice address

1777 Atlanta Ave Ste G1
Riverside, CA 92507-7417

Phone

(951) 778-3504

NPI assigned

Dec 17, 2012

Last updated

Dec 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathaniel Tollefson, CADC 11

Title

Supervisor

Phone

(951) 778-3504

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1386980555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 ATLANTA AVE STE G1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077417",
            "telephone_number": "951-778-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 ATLANTA AVE STE G1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077417",
            "telephone_number": "951-778-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE COUNTY DEPT MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "TOLLEFSON",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "951-778-3504",
        "authorized_official_credential": "CADC 11"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "HO502091228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside County Department of Mental Health
• Riverside County Department of Mental Health
• Riverside County Department of Mental Health
• Riverside County Department of Mental Health
• Riverside County Department of Mental Health
• Riverside County Dept of Mental Health (MHSA FSP SMART-Western)
• Riverside County Dept of Mental Health
• Riverside County Dept of Mental Health (Public Guardian)
• Riverside County Dept of Mental Health
• Riverside County Dept of Mental Health

• Health Maintenance Organization in Riverside, CA
• Providers in Riverside, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.