# RIVERSIDE COUNTY DEPT MENTAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386980555
- **Authorized official:** NATHANIEL TOLLEFSON CADC 11 (SUPERVISOR)
- **Authorized official phone:** (951) 778-3504

## Contact information

- **Practice address:** 1777 ATLANTA AVE STE G1, RIVERSIDE, CA 92507-7417
- **Practice address phone:** (951) 778-3504
- **Mailing address:** 1777 ATLANTA AVE STE G1, RIVERSIDE, CA 92507-7417
- **Mailing address phone:** (951) 778-3504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | HO502091228 | CA | Yes |

## Other

- **Enumeration date:** 12/17/2012
- **Last updated:** 12/17/2012