Provider Demographics
NPI:1972849271
Name:RIVERSIDE RECOVERY RESOURCES
Entity Type:Organization
Organization Name:RIVERSIDE RECOVERY RESOURCES
Other - Org Name:BETA PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, RAS, PHD
Authorized Official - Phone:951-294-5882
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92531-0549
Mailing Address - Country:US
Mailing Address - Phone:951-294-5882
Mailing Address - Fax:951-294-5806
Practice Address - Street 1:4355 CAMINO REAL
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92509-3455
Practice Address - Country:US
Practice Address - Phone:951-294-5882
Practice Address - Fax:951-294-5806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder