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General NPI Number Information
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NPI Number | 1912052184
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Entity Type | Organization
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Legal Business Name | RIVER OAK CENTER FOR CHILDREN
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 9412 BIG HORN BLVD. STE .6
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City | ELK GROVE
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State | CA
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Zip | 95758
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Country | US
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Telephone | 916-228-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 9412 BIG HORN BLVD.
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City | ELK GROVE
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State | CA
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Zip | 95758
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Country | US
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Telephone | 916-228-2600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAURIE CLOTHIER
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Credential |
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Telephone | 916-609-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | CA
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