Provider Demographics
NPI:1982094629
Name:COUNTY OF RIVERSIDE
Entity Type:Organization
Organization Name:COUNTY OF RIVERSIDE
Other - Org Name:DEPARTMENT OF MENTAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:RN IV
Authorized Official - Prefix:
Authorized Official - First Name:RHEMIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:DUMLAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-724-8545
Mailing Address - Street 1:31760 CASINO DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4561
Mailing Address - Country:US
Mailing Address - Phone:951-471-4600
Mailing Address - Fax:951-471-4623
Practice Address - Street 1:31760 CASINO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4561
Practice Address - Country:US
Practice Address - Phone:951-471-4600
Practice Address - Fax:951-471-4623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA492917251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health