OrganizationActive
Carolyn E. Wylie Center
NPI 1972838670 · Point of Service · Riverside, CA
Provider details
- NPI number
- 1972838670
- Entity type
- Organization
- Primary specialty
- Point of ServiceManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Mickey Robinson, Ceo(951) 683-5193
- License
- 60910 (CA)
Specialties & taxonomies
Managed Care Organizations
Practice location
4164 Brockton Ave
Riverside, CA 92501-3400
Phone: (951) 683-5193
Fax: (951) 683-6019
Approximate (ZIP-level) locationGet directions
Mailing address
4164 Brockton Ave
Riverside, CA 92501-3400
Registry dates
- Enumerated
- 2009-10-14
- Last updated
- 2021-05-17
- Certified
- 2021-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.