| Organization Name: | RIVERSIDE RECOVERY RESOURCES |
| NPI Number: | 1003138512 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DERRICK BRUCE HARVEY (EXECUTIVE DIRECTORE) |
| Mailing Address: | 21800 Caynon Drive Wildomar |
| State: | CA US |
| Postal Code: | 925959181 |
| Phone Number: | 9516745354 |
| Fax Number: | 9516745227 |
| NPI Enumeration Date: | 02/25/2010 |
| NPI Last Update Date: | 02/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |