Healthcare Provider Details
I. General information
NPI: 1154487304
Provider Name (Legal Business Name): RIVERVALLEY BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 WALNUT ST
OWENSBORO KY
42301-2956
US
IV. Provider business mailing address
PO BOX 1637
OWENSBORO KY
42302-1637
US
V. Phone/Fax
- Phone: 270-689-6500
- Fax:
- Phone: 270-689-6500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
HICKS
Title or Position: CFO
Credential:
Phone: 270-689-6500