Organization Name: | RIVERSIDE RECOVERY RESOURCES |
NPI Number: | 1083902829 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LOIS ANN EASTERLING (CONTRACT ADMINISTRATOR) |
Mailing Address: | 418 E. Ellis Ave Perris Lake Continuation Hs Perris |
State: | CA US |
Postal Code: | 92571 |
Phone Number: | 9519406061 |
Fax Number: | 9516745227 |
NPI Enumeration Date: | 07/14/2011 |
NPI Last Update Date: | 07/14/2011 |
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: |