RIVERSIDE LIFE SERVICES INC NPI 1114288586

NPI Information

RIVERSIDE LIFE SERVICES, INC is a community health clinic center in Riverside, CA. RIVERSIDE LIFE SERVICES, INC NPI is 1114288586. The provider is registered as an organization entity type.
The provider Other Name Is Riverside Life Services.

The provider's business location address is:

3727 MCCRAY ST
RIVERSIDE, CA
ZIP 92506-928
Phone: (951) 784-2422
Fax: (951) 276-2907

The provider's authorized official is Thomas Minahan .
The authorized official title is Medical Director and has the following contact phone number (951) 340-1002.

The CLIA number assigned to this NPI record is 05D2028096 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/1/2012 and was last updated on 6/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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