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NPI Code Detail

MEDICARE: RIVERSIDE CARE, INC

MEDICARE: RIVERSIDE CARE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center807327PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477660470
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERSIDE CARE, INC
Provider Business Mailing Address
First Line : 499 N 5TH ST
Second Line : STE A
City : PHILADELPHIA
State : PA
Zip : 19123-4005
Country : US
Telephone Number : 215-451-7000
Fax Number : 215-925-6897
Provider Business Practice Location Address
First Line : 2701 N. BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19132-2743
Country : US
Telephone Number : 215-221-0800
Fax Number : 215-221-0487
Authorized Official
Title or Position : CFO
Name : MR. JONATHAN P. SOLOMONS
Credential :
Telephone Number : 215-451-7000
Provider Enumeration Date : 08/24/2006
Last Update Date : 11/02/2010

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Directions to “RIVERSIDE CARE, INC ” Practice Location

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