LIFE SOURCE SOLUTIONS, INC (NPI# 1609004563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609004563 |
| Entity Type | Organization |
| Organization Name | LIFE SOURCE SOLUTIONS, INC |
| Practice Address |
4107 Mission Inn Ave Riverside CA 92501 |
| Mailing Address |
Po Box 529 Riverside CA 92501 |
| Practice Telephone | 9516827143 |
| Practice Fax Number | 9516841135 |
| Mailing Telephone | 9516827143 |
| Mailing Fax Number | 9516841135 |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-06-30 |
| Authorized Official Name | MRS. AVIS C ATTAWAY (OWNER) |
| Authorized Official Telephone | 9515229370 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
4107 MISSION INN AVE |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427158369 | Avis C Attaway | Marriage & Family Therapist | 4107 Mission Inn Ave, Riverside, CA 92501 | 2006-09-22 |
| 1134358666 | Guy Francis Balice | Psychologist | 4107 Mission Inn Ave, Riverside, CA 92501-3125 | 2009-07-06 |
| 1124256342 | Paul Bruce Velen | Marriage & Family Therapist | 4107 Mission Inn Ave, Riverside, CA 92501-3125 | 2009-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255579215 | Hacienda Village | Clinic/Center | 1435 University Ave, Riverside, CA 92507-4466 | 2009-01-29 |
| 1639565856 | Xiaoying Cui, M.d., A Professional Corporation | Clinic/Center | 5900 Brockton Ave, Riverside, CA 92506-1862 | 2015-04-14 |
| 1902219751 | County of Riverside Mental Health | Clinic/Center | 5256 Mission Blvd, Riverside, CA 92509-4624 | 2014-06-10 |
| 1245652437 | Riverside County Mental Health | Clinic/Center | 769 Blaine St, Suite B, Riverside, CA 92507 | 2014-01-08 |
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| 1972112712 | County of Kern | Clinic/Center | 316 Kentucky, Bakersfield, CA 93305 | 2020-07-28 |
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| Find all providers with the same taxonomy | ||||
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| 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.