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Organization

COUNTY OF RIVERSIDE

Active
Other names
MH DENTENTION - JOHN BENOIT DETENTION CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW CHANG (DIRECTOR RUHS - BEHAVIORAL HEALTH)
(951) 358-4500
Entity
Organization

Contact information

Practice address
82675 US HIGHWAY 111, INDIO, CA 92201-5635
(760) 863-8037
Mailing address
4095 COUNTY CIRCLE DR, RIVERSIDE, CA 92503-3410
(951) 358-6900

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00033
LEGAL ENTITY
CA
01
3334
STATE PROVIDER
CA
Enumeration date
04/03/2020
Last updated
10/12/2022
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