Organization
COUNTY OF RIVERSIDE
Active
Other names
CalWORKs Lake Elsinore
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
1400 W MINTHORN ST, LAKE ELSINORE, CA 92530-2808
(951) 245-3207
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
—
3335
STATE PROVIDER
CA
Enumeration date
04/21/2020
Last updated
10/13/2022
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