Healthcare Provider Details

I. General information

NPI: 1629852884
Provider Name (Legal Business Name): EVA RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 E 16TH ST STE 260
HOLLAND MI
49423-3796
US

IV. Provider business mailing address

355 S LAKESHORE DR
HOLLAND MI
49424-2220
US

V. Phone/Fax

Practice location:
  • Phone: 616-522-4225
  • Fax:
Mailing address:
  • Phone: 616-212-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851122085
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: