Healthcare Provider Details

I. General information

NPI: 1508487901
Provider Name (Legal Business Name): RIVER CITY RESIDENTIAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 HUNGARY RD
RICHMOND VA
23228-2208
US

IV. Provider business mailing address

PO BOX 2549
GLEN ALLEN VA
23058-2549
US

V. Phone/Fax

Practice location:
  • Phone: 804-230-0999
  • Fax:
Mailing address:
  • Phone: 804-230-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMES CHRISTMAS III
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 804-230-0999