NPI 1023327541

Health View

Organisation Mental Illness Community Based Residential Treatment Facility Riverside, CA

Practice location

Address: 5880 Fair Isle Dr APT 166, Riverside, CA 92507-8458
Phone: (310) 869-1252
Mailing address: 921 S Beacon St, San Pedro, CA 90731-3740

Authorised official

Name: Micheal Fitzgerald
Title: Director
Phone: (310) 984-3055

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in California →

Registry record

NPI: 1023327541
Entity type: Organization
NPI issued: 1 Oct 2010
Record last updated: 1 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.