| Riverside Su Day Reporting Center | |
|
1020 Iowa Ave Ste B Riverside CA 92507-2105 | |
| (951) 955-1503 | |
| Not Available |
| Full Name | Riverside Su Day Reporting Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1020 Iowa Ave Ste B, Riverside, California |
| Authorized Official Name and Position | Jerry Wengerd (DIRECTOR OF MENTAL HEALTH) |
| Authorized Official Contact | 9513584500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Su Day Reporting Center 4095 County Circle Dr Riverside CA 92503-3410 Ph: (951) 358-6900 | Riverside Su Day Reporting Center 1020 Iowa Ave Ste B Riverside CA 92507-2105 Ph: (951) 955-1503 |
| NPI Number | 1225409899 |
|---|---|
| Provider Enumeration Date | 10/08/2015 |
| Last Update Date | 10/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225409899 | NPI | - | NPPES |
| 00033 | Other | CA | LEGAL ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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