Healthcare Provider Details

I. General information

NPI: 1003726621
Provider Name (Legal Business Name): RIVERBEND RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 RIVER BEND DR
LATHROP CA
95330-7088
US

IV. Provider business mailing address

915 RIVER BEND DR
LATHROP CA
95330-7088
US

V. Phone/Fax

Practice location:
  • Phone: 209-774-0731
  • Fax: 866-892-3394
Mailing address:
  • Phone: 209-774-0731
  • Fax: 866-892-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ROSS MORTON
Title or Position: CEO
Credential: J.D
Phone: 916-741-5312