Healthcare Provider Details

I. General information

NPI: 1457272973
Provider Name (Legal Business Name): RIVERSTONE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MANHATTAN DR STE 207
BOULDER CO
80303-4253
US

IV. Provider business mailing address

75 MANHATTAN DR STE 207
BOULDER CO
80303-4253
US

V. Phone/Fax

Practice location:
  • Phone: 720-802-6925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: FLOYD YOUNG III
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 503-997-5635