Provider Demographics
NPI:1912041120
Name:COUNTY OF RIVERSIDE DEPARTMENT MENTAL HEALTH
Entity Type:Organization
Organization Name:COUNTY OF RIVERSIDE DEPARTMENT MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH SPECIALIST III
Authorized Official - Prefix:MS
Authorized Official - First Name:JOI
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-276-3069
Mailing Address - Street 1:3768 10TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3621
Mailing Address - Country:US
Mailing Address - Phone:951-276-3069
Mailing Address - Fax:951-275-0527
Practice Address - Street 1:3768 10TH ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3621
Practice Address - Country:US
Practice Address - Phone:951-276-3069
Practice Address - Fax:951-275-0527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management