Organization
RIVERSIDE COUNTY DEPT MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL TOLLEFSON CADC 11 (SUPERVISOR)
(951) 778-3504
Entity
Organization
Contact information
Practice address
1777 ATLANTA AVE STE G1, RIVERSIDE, CA 92507-7417
(951) 778-3504
Mailing address
1777 ATLANTA AVE STE G1, RIVERSIDE, CA 92507-7417
(951) 778-3504
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
HO502091228
CA
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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