Healthcare Provider Details

I. General information

NPI: 1548036403
Provider Name (Legal Business Name): RIVERSIDE SELECT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 W MERRICK RD STE 12
FREEPORT NY
11520-3357
US

IV. Provider business mailing address

294 W MERRICK RD STE 12
FREEPORT NY
11520-3357
US

V. Phone/Fax

Practice location:
  • Phone: 516-367-2266
  • Fax:
Mailing address:
  • Phone: 516-367-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLEN STEIN
Title or Position: MEMBER
Credential:
Phone: 917-337-0110