Active NPI
County of Riverside
- Community/Behavioral Health Agency
- Perris, CA
National Provider Identifier
1720148257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- COUNTY OF RIVERSIDE
- Practice address
- 308 E San Jacinto Ave
Perris, CA 92570-2878 - Phone
- (951) 358-6900
- Fax
- (951) 358-6905
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Matthew Chang
- Title
- Director Ruhs - Behavioral Health
- Phone
- (951) 358-6900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
308 E San Jacinto Ave
Perris, CA 92570-2878
Mailing address
PO Box 7549
Riverside, CA 92513-7549
Phone (951) 358-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33GX | Medicaid | CA |
Other names 1
- Mid-County Multi-Dimensional Family Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| 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
National Provider Directory- Tax ID family
- Riverside County Dept
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Behavioral Health Agency
- San Jacinto, CA
- NPI 1659738813
-
- Community/Behavioral Health Agency
- Cathedral City, CA
- NPI 1669092516
-
- Dental Clinic/Center
- Riverside, CA
- NPI 1669880753
-
- Community/Behavioral Health Agency
- Desert Hot Springs, CA
- NPI 1679771752
-
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1699266049
-
- Institutional Pharmacy
- Riverside, CA
- NPI 1710125638
-
- Community/Behavioral Health Agency
- Temecula, CA
- NPI 1710361688
-
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1720148323
-
- Community/Behavioral Health Agency
- Hemet, CA
- NPI 1720936396
-
- Clinic Pharmacy
- Riverside, CA
- NPI 1730216607
-
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1730515032
-
- Public Health or Welfare Agency
- Riverside, CA
- NPI 1740402783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662681600000",
"number": "1720148257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7549",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925137549",
"telephone_number": "951-358-6900",
"fax_number": "951-358-6905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 E SAN JACINTO AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925702878",
"telephone_number": "951-358-6900",
"fax_number": "951-358-6905"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF RIVERSIDE",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-12",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A",
"authorized_official_last_name": "CHANG",
"authorized_official_first_name": "MATTHEW",
"authorized_official_title_or_position": "DIRECTOR RUHS - BEHAVIORAL HEALTH",
"authorized_official_telephone_number": "951-358-6900",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33GX",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mid-County Multi-Dimensional Family Therapy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mid-County Multi-Dimensional Family Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.