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Organization
RIVERSIDE SANITARIUM, LLC
Active
Organization
RIVERSIDE SANITARIUM, LLC
Active
Other names
Riverside Behavioral Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WINTNER (MANAGER)
(323) 651-1808
Entity
Organization
Contact information
Practice address
4580 PALM AVENUE, RIVERSIDE, CA 92501
(951) 684-7701
(951) 684-2236
Mailing address
4580 PALM AVENUE, RIVERSIDE, CA 92501
(951) 684-7701
(310) 574-1322
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
250000119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18648I
—
CA
Enumeration date
09/09/2005
Last updated
02/10/2015
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