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General NPI Number Information
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NPI Number | 1144510215
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Entity Type | Organization
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Legal Business Name | RIVERBEND SERVICES, INC.
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 6688 NC HIGHWAY 41 N
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City | LUMBERTON
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State | NC
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Zip | 28358-2501
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Country | US
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Telephone | 910-618-9260
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Fax | 910-737-6505
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Provider Business Mailing Address
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Address Line | 6688 NC HIGHWAY 41 N
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City | LUMBERTON
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State | NC
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Zip | 28358-2501
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Country | US
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Telephone | 910-618-9260
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Fax | 910-737-6505
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANGIE ROUSE
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Credential | BS
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Telephone | 910-618-9260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NC
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Taxonomy #7
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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 | MHL-078-166
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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