Healthcare Provider Details

I. General information

NPI: 1609498328
Provider Name (Legal Business Name): RIVERSTONE BILLING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6451 MCCALL ST # D
BONNERS FERRY ID
83805-8525
US

IV. Provider business mailing address

PO BOX 3101
BONNERS FERRY ID
83805-3101
US

V. Phone/Fax

Practice location:
  • Phone: 208-267-2070
  • Fax: 208-267-3160
Mailing address:
  • Phone: 208-267-2070
  • Fax: 208-267-3160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: CASADY BRIMHALL
Title or Position: PRESIDENT
Credential:
Phone: 208-267-2070