Provider Demographics
NPI:1851864060
Name:RIVERSIDE LATINO COMMISSION ON ALCOHOL & DRUG ABUSE SERVICES, INC.
Entity Type:Organization
Organization Name:RIVERSIDE LATINO COMMISSION ON ALCOHOL & DRUG ABUSE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-398-9000
Mailing Address - Street 1:1612 1ST ST
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1407
Mailing Address - Country:US
Mailing Address - Phone:760-398-9000
Mailing Address - Fax:760-398-9790
Practice Address - Street 1:91275 66TH AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:MECCA
Practice Address - State:CA
Practice Address - Zip Code:92254
Practice Address - Country:US
Practice Address - Phone:760-863-7860
Practice Address - Fax:760-398-9790
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERSIDE LATINO COMMISSION ON ALCOHOL & DRUG ABUSE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health