Healthcare Provider Details

I. General information

NPI: 1306905518
Provider Name (Legal Business Name): RIVER CITY RECOVERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12490 ALTA MESA ROAD
HERALD CA
95638
US

IV. Provider business mailing address

500 22ND ST
SACRAMENTO CA
95816-3503
US

V. Phone/Fax

Practice location:
  • Phone: 916-442-3979
  • Fax: 916-442-3577
Mailing address:
  • Phone: 916-442-3979
  • Fax: 916-442-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SUMNER OFFILL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-442-3979