Organization
PERRIS VALLEY RECOVERY PROGRAM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINYA K HOLT (PRESIDENT/CEO)
(951) 657-2960
Entity
Organization
Contact information
Practice address
236 E 3RD ST, SUITE B, PERRIS, CA 92570-2223
(951) 657-2960
(951) 940-4600
Mailing address
236 E 3RD ST, SUITE B, PERRIS, CA 92570-2223
(951) 657-2960
(951) 940-4600
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3312
—
CA
Enumeration date
09/13/2006
Last updated
08/22/2020
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