Organization Name: | COUNTY OF RIVERSIDE |
NPI Number: | 1265505762 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN JOHNSON MORA (CMS BRANCH CHIEF) |
Mailing Address: | 10353 Gramercy Pl Riverside |
State: | CA US |
Postal Code: | 925051334 |
Phone Number: | 9516873113 |
Fax Number: | 9513591747 |
NPI Enumeration Date: | 11/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |