Organization
COUNTY OF RIVERSIDE
Active
Other names
Blythe Substance Use Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY A WENGERD (DIRECTOR, DEPT. OF MENTAL HEALTH)
(951) 358-4501
Entity
Organization
Contact information
Practice address
1297 W HOBSONWAY, BLYTHE, CA 92225-1423
(760) 921-5019
(760) 921-5010
Mailing address
3525 PRESLEY AVE, RIVERSIDE, CA 92507-4453
(951) 782-2400
(951) 683-4904
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
333365
CADDS
CA
05
—
3365
—
CA
Enumeration date
11/28/2006
Last updated
12/10/2014
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