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General NPI Number Information
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NPI Number | 1821507930
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Entity Type | Organization
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Legal Business Name | RIVERWOOD GROUP, LLC
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 42 GODLEY RD
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City | SAINT HELENA ISLAND
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State | SC
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Zip | 29920-5113
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Country | US
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Telephone | 402-033-9143
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Fax | 402-592-5901
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Provider Business Mailing Address
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Address Line | 42 GODLEY RD
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City | SAINT HELENA ISLAND
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State | SC
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Zip | 29920-5113
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Country | US
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Telephone | 402-033-9143
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Fax | 402-592-5901
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Authorized Official
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Title or Position | DIRECTOR OF QUALITY MANAGEMENT
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Name | JIM WEISS
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Credential |
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Telephone | 402-339-1436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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