Organization
COUNTY OF RIVERSIDE
Active
Organization
COUNTY OF RIVERSIDE
Active
Other names
JEFFERSON WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW CHANG (DIRECTOR RUHS - BEHAVIORAL HEALTH)
(951) 358-4501
Entity
Organization
Contact information
Practice address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 955-8000
(951) 955-8010
Mailing address
PO BOX 7549, RIVERSIDE, CA 92513-7549
(951) 358-6900
(951) 358-6905
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
05
—
3373
—
CA
05
—
ZZZ30059Z
—
CA
Enumeration date
11/21/2006
Last updated
10/12/2022
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