County of Riverside
Organization Active NPI Community/Behavioral Health Agency · Riverside, CA
NPI 1487096020 · NPPES record last updated Sep 9, 2022
Key facts
- NPI
- 1487096020
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- COUNTY OF RIVERSIDE
- Practice address
- 3625 14TH St
Riverside, CA 92501-3815 - Phone
- (951) 358-6919
- NPI assigned
- Jul 24, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Matthew Chang
- Title
- Director Ruhs - Behavioral Health
- Phone
- (951) 358-4500
Corporate family (same tax ID) 24
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310001107 | CA | Part B Supplier - Clinic/Group Practice | 6507754488 |
Receives reassigned benefits from 362 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Riverside County Dept
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
3625 14TH St
Riverside, CA 92501-3815
Mailing address
PO Box 7659
Riverside, CA 92513
Phone (951) 358-6900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00033 | Other | CA | LEGAL ENTITY |
Other names
- IMD Case Management
Other providers in Riverside, CA
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
All providers in Riverside, CA · Community/Behavioral Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.