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NPI 1073480109 · Community/Behavioral Health Agency · Riverside, CA
Provider details
- NPI number
- 1073480109
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Ernestine Grissom, Founder & Ceo Or Executive Director(951) 470-7802
Specialties & taxonomies
Agencies
- Case Management Agency251B00000X
Agencies
- Public Health or Welfare Agency251K00000X
Agencies
- Voluntary or Charitable Agency251V00000X
Agencies
- Early Intervention Provider Agency252Y00000X
Agencies
- In Home Supportive Care Agency253Z00000X
Agencies
- Meals Provider174200000X
Other Service Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8546 Glencoe Dr
Riverside, CA 92504-2316
Phone: (951) 470-7802
Street-level locationGet directions
Mailing address
8546 Glencoe Dr
Riverside, CA 92504-2316
Registry dates
- Enumerated
- 2025-10-22
- Last updated
- 2025-10-22
- Certified
- 2025-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.