Organization
COUNTY OF RIVERSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN CRUIKSHANK (CEO)
(951) 486-4135
Entity
Organization
Contact information
Practice address
26600 CACTUS AVE STE 300, MORENO VALLEY, CA 92555-3901
(951) 988-9500
Mailing address
26600 CACTUS AVE STE 300, MORENO VALLEY, CA 92555-3901
(951) 988-9500
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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