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General NPI Number Information
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NPI Number | 1427531169
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Entity Type | Organization
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Legal Business Name | RIVERRIDGE TREATMENT CENTER
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 7000 N STATELINE
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City | TEXARKANA
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State | AR
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Zip | 71854
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Country | US
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Telephone | 870-774-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 2904 ARKANSAS BLVD
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City | TEXARKANA
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State | AR
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Zip | 71854-2536
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MITCH FRANCES
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Credential |
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Telephone | 870-773-4655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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