Provider Demographics
NPI:1720207764
Name:RIVERSIDE COUNTY DEPARTMENT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:RIVERSIDE COUNTY DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH SPECIALIST III
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRY
Authorized Official - Suffix:
Authorized Official - Credentials:CADDE
Authorized Official - Phone:951-304-5776
Mailing Address - Street 1:25827 MARGARET AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-7019
Mailing Address - Country:US
Mailing Address - Phone:951-304-5776
Mailing Address - Fax:951-304-5777
Practice Address - Street 1:1777 ATLANTA AVE
Practice Address - Street 2:G1
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-7417
Practice Address - Country:US
Practice Address - Phone:951-304-5776
Practice Address - Fax:951-304-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health