Healthcare Provider Details

I. General information

NPI: 1407991409
Provider Name (Legal Business Name): RIVERBEND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 JACKSON ST 4TH FLOOR
LOWELL MA
01852-2103
US

IV. Provider business mailing address

101 JACKSON ST 4TH FLOOR
LOWELL MA
01852-2103
US

V. Phone/Fax

Practice location:
  • Phone: 978-459-8656
  • Fax: 978-937-2559
Mailing address:
  • Phone: 978-459-8656
  • Fax: 978-937-2559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number0282
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0554
License Number StateMA

VIII. Authorized Official

Name: LITMARIE REYES MELENDEZ
Title or Position: BILLING & CREDENTIALING ANALYST
Credential:
Phone: 978-788-8879