Healthcare Provider Details

I. General information

NPI: 1104370428
Provider Name (Legal Business Name): RIVERSTONE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 MEADOW LAKE BLVD
COLUMBIA FALLS MT
59912-4629
US

IV. Provider business mailing address

PO BOX 771
EFFINGHAM IL
62401-0771
US

V. Phone/Fax

Practice location:
  • Phone: 406-892-3400
  • Fax:
Mailing address:
  • Phone: 217-821-9539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SANDRA WILSON
Title or Position: ACCOUNTANT
Credential:
Phone: 217-342-2870