Healthcare Provider Details
I. General information
NPI: 1023651676
Provider Name (Legal Business Name): RIVER TO RECOVERY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2019
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1507 PLEASANT ST
FALL RIVER MA
02723-1914
US
IV. Provider business mailing address
901 EASTERN AVE
FALL RIVER MA
02723-2848
US
V. Phone/Fax
- Phone: 774-704-5501
- Fax:
- Phone: 774-704-5501
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
JEAN
WASHINGTON
Title or Position: CEO
Credential: MS, LADC 1
Phone: 774-704-5501