# RIVERSIDE SANITARIUM, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Behavioral Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245224732
- **Authorized official:** JACOB WINTNER (MANAGER)
- **Authorized official phone:** (323) 651-1808

## Contact information

- **Practice address:** 4580 PALM AVENUE, RIVERSIDE, CA 92501
- **Practice address phone:** (951) 684-7701
- **Practice address fax:** (951) 684-2236
- **Mailing address:** 4580 PALM AVENUE, RIVERSIDE, CA 92501
- **Mailing address phone:** (951) 684-7701
- **Mailing address fax:** (310) 574-1322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 250000119 | CA | Yes |

## Other

- **Enumeration date:** 09/09/2005
- **Last updated:** 02/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT18648I | — | CA |