Healthcare Provider Details

I. General information

NPI: 1912832239
Provider Name (Legal Business Name): RIVERBEND HEAD START & FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 E BROADWAY
ALTON IL
62002-6664
US

IV. Provider business mailing address

1848 E BROADWAY
ALTON IL
62002-6664
US

V. Phone/Fax

Practice location:
  • Phone: 618-463-5946
  • Fax: 618-463-5901
Mailing address:
  • Phone: 618-463-5946
  • Fax: 618-463-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: TIM WARREN
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 618-463-8729