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General NPI Number Information
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NPI Number | 1831758507
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Entity Type | Organization
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Legal Business Name | RIVES RESIDENTIAL FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 4230 FAYETTE CIR
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City | RICHMOND
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State | VA
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Zip | 23222-1323
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Country | US
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Telephone | 804-550-8156
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Fax |
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Provider Business Mailing Address
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Address Line | 8702 QUEENSMERE PL APT 7
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City | HENRICO
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State | VA
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Zip | 23294-4861
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Country | US
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Telephone | 804-550-8156
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KANDYCE RIVES
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Credential |
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Telephone | 804-550-8156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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