# RIVERSIDE LIFE SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Life Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114288586
- **Authorized official:** DR. THOMAS MINAHAN DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (951) 340-1002

## Contact information

- **Practice address:** 3727 MCCRAY ST, RIVERSIDE, CA 92506-2928
- **Practice address phone:** (951) 784-2422
- **Practice address fax:** (951) 276-2907
- **Mailing address:** 3727 MCCRAY ST, RIVERSIDE, CA 92506-2928
- **Mailing address phone:** (951) 784-2422
- **Mailing address fax:** (951) 276-2907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/01/2012
- **Last updated:** 06/01/2012