Organization
COUNTY OF RIVERSIDE
Active
Other names
IMD Case Management
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
3625 14TH ST, RIVERSIDE, CA 92501-3815
(951) 358-6919
Mailing address
PO BOX 7659, RIVERSIDE, CA 92513
(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
Enumeration date
07/24/2013
Last updated
09/09/2022
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