Basic Information
| Provider Information | |||||||||
| NPI: | 1033471917 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIVERWOOD MENTAL HEALTH SERVICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 RAILROAD AVE | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028853206 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 25 RAILROAD AVE | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028853206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012474278 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2012 | ||||||||
| LastUpdateDate: | 06/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | KUBAS-MEYER | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4012474278 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | RN45198 | RI | Y | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
No ID Information.