417 SOUTH RIVER LLC – NPI #1891571659
Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
417 SOUTH RIVER LLC is a substance abuse rehabilitation facility located in MURRIETA, CA. NPPES has assigned the NPI number 1891571659 to 417 SOUTH RIVER LLC on September 06, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3245S0500X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility, specializing in Substance Abuse Treatment, Children
The NPI profile was last updated on May 21, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 417 SOUTH RIVER LLC below.
NPI Profile for
417 SOUTH RIVER LLC
(about 3 years ago)
MURRIETA, CA 92563-2489 Phone: (760) 485-6563 Fax:
MURRIETA, CA 92563-2491 Phone: (760) 485-6563 Fax:
OWNER/PARTNER
Phone: (760) 485-6563
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 3245S0500X - Substance Abuse Rehabilitation Facility / Substance Abuse Treatment, Children (Primary) |
||
| 261QM0855X - Clinic/Center / Adolescent and Children Mental Health |
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| 251S00000X - Community/Behavioral Health |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.