NPIMap

Organization Active NPI

Riverside Recovery Resources

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Riverside, CA
National Provider Identifier
1730414707
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
330009QN Issued in CA
Legal business name
RIVERSIDE RECOVERY RESOURCES
Practice address
3757 Elizabeth St
Riverside, CA 92506-2508
Phone
(951) 674-7354
Fax
(951) 674-5227
NPI assigned
Oct 8, 2009
Last updated
Oct 8, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE RECOVERY RESOURCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Authorized official

Name
Derrick Bruce Harvey, CAS II
Title
Executive Director
Phone
(951) 674-7354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 330009QN CA Primary

Addresses

Primary practice location

3757 Elizabeth St
Riverside, CA 92506-2508

Mailing address

PO Box 549
Lake Elsinore, CA 92531-0549
Phone (951) 674-7354

Other names 1

  • Omega / Beta Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Riverside Recovery Resources Inc45 organizations share this tax ID, including this one
Part of
Riverside Recovery Resources Inc

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Locations

3757 Elizabeth St
Riverside, CA 92506
Phone (951) 674-7354

Practitioners & affiliated clinicians

Practitioners 2

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": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1730414707",
    "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": "951-674-7354",
            "fax_number": "951-674-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3757 ELIZABETH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062508",
            "telephone_number": "951-674-7354",
            "fax_number": "951-674-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RECOVERY RESOURCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE RECOVERY RESOURCES",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "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": "951-674-7354",
        "authorized_official_credential": "CAS II"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "330009QN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omega / Beta Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.