COUNTY OF RIVERSIDE


Address: 31764 Casino Dr, Suite 300, Lake Elsinore, CA 92530-4571
Phone: 9513586900

COUNTY OF RIVERSIDE (NPI# 1356748628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356748628
Entity Type Organization
Organization Name COUNTY OF RIVERSIDE
Other Organization Name LAKE ELSINORE FAMILY CARE CENTER - MENTAL HEALTH
Practice Address 31764 Casino Dr
Suite 300
Lake Elsinore
CA 92530-4571
Mailing Address 4095 County Circle Dr
Riverside
CA 92503-3410
Practice Telephone 9513586900
Mailing Telephone 9513586900
Enumeration Date 2014-12-02
Last Update Date 2016-11-21
Authorized Official Name JERRY WENGERD (DIRECTOR OF MENTAL HEALTH)
Authorized Official Telephone 9513584500
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health Agencies

Other Provider Identifier

State Issuer Identifier Type Code
CA LEGAL ENTITY 00033 01

Other Provider/Organization Names

Other Name Type Code
Lake Elsinore Family Care Center - Mental Health Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1821618588 County of Riverside Community/Behavioral Health 63 S 4th St, Banning, CA 92220-4861 2020-04-23
1003436940 County of Riverside Community/Behavioral Health 1225 W Hobsonway, Blythe, CA 92225-1423 2020-04-21
1457971301 County of Riverside Community/Behavioral Health 65753 Pierson Blvd, Desert Hot Springs, CA 92240-3067 2020-04-21
1184244345 County of Riverside Community/Behavioral Health 1283 6th St, Coachella, CA 92236-1707 2020-04-17
1386264562 County of Riverside Community/Behavioral Health 517 Parkridge Ave, Norco, CA 92860-3103 2020-04-17
1942839816 County of Riverside Community/Behavioral Health 91-275 Ave 66, Mecca, CA 92254 2020-04-03
1235768110 County of Riverside Community/Behavioral Health 82675 Us Highway 111, Indio, CA 92201-5635 2020-04-03
1609408178 County of Riverside Pharmacy 26600 Cactus Ave, Moreno Valley, CA 92555-3901 2020-02-12
1982243812 County of Riverside Clinic/Center 26600 Cactus Ave Ste 300, Moreno Valley, CA 92555-3901 2019-12-23
1467943811 County of Riverside Community/Behavioral Health 249 N Spring St, Blythe, CA 92225 2018-05-22

Office Location

Street Address 31764 CASINO DR
SUITE 300
City LAKE ELSINORE
State CA
Zip Code 92530-4571

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851375059 Ronald Andrew Toth II Physical Therapist 31764 Casino Dr, Ste 106-a, Lake Elsinore, CA 92530-4571 2005-12-01
1154957587 Marisol Canett Licensed Vocational Nurse 31764 Casino Dr, Lake Elsinore, CA 92530-2312 2020-03-17
1356823207 Tina Giordano Licensed Vocational Nurse 31764 Casino Dr, Lake Elsinore, CA 92530-4571 2018-09-06
1245759091 Tracey Denise Hauser Licensed Vocational Nurse 31764 Casino Dr, Lake Elsinore, CA 92530-4571 2017-09-13
1063946903 Taylor L Jump Physical Therapist 31764 Casino Dr, Suite 106, Lake Elsinore, CA 92530-4571 2017-04-18
1164960951 Kathryn Robbins Peer Specialist 31764 Casino Dr, Ste 300, Lake Elsinore, CA 92530-4571 2017-02-01
1700239084 Haillie Ann Stober Case Manager/Care Coordinator 31764 Casino Dr, Suite 300, Lake Elsinore, CA 92530-4571 2016-07-21
1811368806 Holis Gardner Licensed Vocational Nurse 31764 Casino Dr, Ste 300, Lake Elsinore, CA 92530-4571 2015-10-15
1205206869 Susana Murillo Case Manager/Care Coordinator 31764 Casino Dr, Ste 300, Lake Elsinore, CA 92530-4571 2015-09-25
1265839187 Tara C Renzetti Case Manager/Care Coordinator 31764 Casino Dr, Suite 300, Lake Elsinore, CA 92530-4571 2014-11-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841801479 Mercedes Samantha Hamilton Licensed Psychiatric Technician 18465 Grand Ave, Lake Elsinore, CA 92530 2020-08-17
1700423779 Karrene Louise Stanard Peer Specialist 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 2019-12-09
1972149961 Danielle Cravalho Student in an Organized Health Care Education/Training Program 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 2019-11-25
1952825648 R.e. Levi Dental Corporation Dentist 32235 Mission Trail # 8, Lake Elsinore, CA 92530 2017-08-03
1144760729 Alfred Metwashla Pharmacist 18269 Collier Ave, Lake Elsinore, CA 92530 2017-03-02
1750788733 Roxanne Martinez Case Manager/Care Coordinator 31764 Casino Drive, Lake Elsinore, CA 92530 2014-11-19
1871870907 Bryan Tuan Tran Pharmacist 160 Diamond Drive, Lake Elsinore, CA 92530 2011-11-03
1043590821 Katherynn Elizabeth Williams Marriage & Family Therapist 600 Central Ave Ste 201, Lake Elsinore, CA 92530 2011-08-24
1861771677 Judy Kelly Marriage & Family Therapist 224 West Graham Ave, Lake Elsinore, CA 92530 2011-08-10
1427343813 Patrick Chern Pharmacist 18287 Collier Ave., Lake Elsinore, CA 92530 2011-06-14
Find all providers in zip 92530

Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871924928 County of Riverside Community/Behavioral Health 31760 & 31764 Casino Dr, Lake Elsinore, CA 92530-4561 2013-11-27
1588967772 Mfi Recovery Center Community/Behavioral Health 1405 Education Way, Lake Elsinore, CA 92530-2809 2010-12-10
1033412226 Mfi Recovery Center Community/Behavioral Health 32593 Riverside Dr, Lake Elsinore, CA 92530-7802 2010-12-10
1093018186 Mfi Recovery Center Community/Behavioral Health 520 Chaney St Bldg 100, Lake Elsinore, CA 92530-2711 2010-12-10
1346860210 County of Riverside Community/Behavioral Health 1400 W Minthorn St, Lake Elsinore, CA 92530-2808 2020-04-21
1831640358 Corc Family Counseling Corporation Community/Behavioral Health 224 W Graham Ave, Lake Elsinore, CA 92530-3740 2016-10-19
1982094629 County of Riverside Community/Behavioral Health 31760 Casino Dr, Suite 100, Lake Elsinore, CA 92530-4561 2015-02-03
1225331416 Mfi Temescal Canyon High School Community/Behavioral Health 28755 El Toro Rd, Lake Elsinore, CA 92532-1912 2010-12-10
1518298702 Community Access Network Community/Behavioral Health 600 Central Ave, Suite E1, Lake Elsinore, CA 92530-2740 2010-01-27
1700030566 County of Riverside Community/Behavioral Health 31946 Mission Trail, Suite B, Lake Elsinore, CA 92530 2008-11-06
Find all providers in LAKE ELSINORE

Competitor

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City LAKE ELSINORE
Zip Code 92530

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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