| The Wylie Center | |
|
4164 Brockton Ave Riverside CA 92501-3400 | |
| (951) 683-5193 | |
| (951) 683-6019 |
| Full Name | The Wylie Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4164 Brockton Ave, Riverside, California |
| Authorized Official Name and Position | Mickey Rubinson (C.E.O.) |
| Authorized Official Contact | 9516835193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Wylie Center 4164 Brockton Ave Riverside CA 92501-3400 Ph: (951) 683-5193 | The Wylie Center 4164 Brockton Ave Riverside CA 92501-3400 Ph: (951) 683-5193 |
| NPI Number | 1437273521 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 08/11/2021 |
| Certification Date | 08/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437273521 | NPI | - | NPPES |
| 33BAA0 | Other | CA | OTHER |
| 33BA00 | Other | CA | OTHER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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