Healthcare Provider Details

I. General information

NPI: 1790958411
Provider Name (Legal Business Name): RIVERWAY COMMUNITIES OF HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N IOWA ST
MUSCODA WI
53573-9021
US

IV. Provider business mailing address

PO BOX 555
MUSCODA WI
53573-0555
US

V. Phone/Fax

Practice location:
  • Phone: 608-929-4970
  • Fax:
Mailing address:
  • Phone: 608-929-4970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARGARET M SCHMITT
Title or Position: BOARD SECRETARY/ TREASURER
Credential:
Phone: 608-537-2921