| Ssg Riverside Counseling Center | |
|
13800 Heacock St Ste C220 Moreno Valley CA 92553-3363 | |
| (951) 653-1800 | |
| (951) 653-1815 |
| Full Name | Ssg Riverside Counseling Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 13800 Heacock St Ste C220, Moreno Valley, California |
| Authorized Official Name and Position | Herbert K Hatanaka (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2135531800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssg Riverside Counseling Center 905 E 8th St Los Angeles CA 90021-1848 Ph: (213) 553-1800 | Ssg Riverside Counseling Center 13800 Heacock St Ste C220 Moreno Valley CA 92553-3363 Ph: (951) 653-1800 |
| NPI Number | 1093217614 |
|---|---|
| Provider Enumeration Date | 02/28/2018 |
| Last Update Date | 05/16/2022 |
| Certification Date | 05/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093217614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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