Knollwood Psychiatric Hospital & Chemical Dependency Center Inc

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

2500476 Issued in CA

Legal business name

KNOLLWOOD PSYCHIATRIC HOSPITAL & CHEMICAL DEPENDENCY CENTER INC

Practice address

5900 Brockton Ave
Riverside, CA 92506-1862

Phone

(951) 275-8400

Fax

(951) 788-4136

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Kennedy

Title

Assist. Business Office Manager

Phone

(951) 275-8400

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Riverside Center for Behavioral Medicine Doing business as

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391644800000",
    "number": "1477633295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061862",
            "telephone_number": "951-275-8400",
            "fax_number": "951-788-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061862",
            "telephone_number": "951-275-8400",
            "fax_number": "951-788-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLWOOD PSYCHIATRIC HOSPITAL & CHEMICAL DEPENDENCY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-02-06",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ASSIST. BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "951-275-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CA",
            "license": "2500476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP34130G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP44130G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Center for Behavioral Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• La Tanya Chanile Knight
• Mara Yvette Knight
• Sonja Franziska Knittel-Hliddal, MD
• Halee Knoefler, PT
• Jennifer Knoll, MA, MT-BC
• Carl George Knopke III, MD
• Dana Knott
• Trevor Knott
• Know Knots Massage
• Douglas Edward Knox, MD

• Psychiatric Hospital in Riverside, CA
• Providers in Riverside, CA by specialty
• Psychiatric Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.