Provider Demographics
NPI:1770770364
Name:COUNTY OF RIVERSIDE DEPARTMENT OF MENTAL HEALTH
Entity type:Organization
Organization Name:COUNTY OF RIVERSIDE DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH SPECIALIST II
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIBET
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-358-4850
Mailing Address - Street 1:9890 COUNTY FARM RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3505
Mailing Address - Country:US
Mailing Address - Phone:951-358-4850
Mailing Address - Fax:
Practice Address - Street 1:9890 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3505
Practice Address - Country:US
Practice Address - Phone:951-358-4850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD1655163251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health