Healthcare Provider Details

I. General information

NPI: 1467393215
Provider Name (Legal Business Name): HIDDEN RIVERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6316 RISING SUN AVE
PHILA PA
19111-5630
US

IV. Provider business mailing address

6316 RISING SUN AVE
PHILA PA
19111-5630
US

V. Phone/Fax

Practice location:
  • Phone: 267-339-4128
  • Fax:
Mailing address:
  • Phone: 267-339-4128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY LEE EPPS
Title or Position: FOUNDER/CAADC, LPC, LBS
Credential: EPPS
Phone: 267-339-4128