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General NPI Number Information
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NPI Number | 1053764456
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Entity Type | Organization
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Legal Business Name | RIVER STONES CHILD AND ADOLESCENT TREATMENT
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 26967 BEAUMONT AVE
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City | REDLANDS
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State | CA
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Zip | 92373
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Country | US
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Telephone | 909-748-7141
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Fax | 909-748-0582
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Provider Business Mailing Address
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Address Line | PO BOX 7340
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City | REDLANDS
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State | CA
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Zip | 92375
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Country | US
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Telephone | 909-748-7141
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Fax | 909-748-0582
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Authorized Official
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Title or Position | CEO
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Name | RUSSELL R RICE
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Credential | LMFT
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Telephone | 909-645-1820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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