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General NPI Number Information
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NPI Number | 1912931023
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Entity Type | Organization
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Legal Business Name | RIVERSIDE CARE INC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 31 SOUTH 10TH AVENUE SUITE 6
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City | COATESVILLE
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State | PA
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Zip | 19320
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Country | US
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Telephone | 610-383-9600
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Fax | 610-383-4811
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Provider Business Mailing Address
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Address Line | 100 EAGLEVILLE ROAD PO BOX 220
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City | EAGLEVILLE
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State | PA
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Zip | 19408-0220
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Country | US
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Telephone | 610-635-7445
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Fax | 610-635-7627
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROSEMARY O'ROURKE
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Credential |
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Telephone | 610-635-7438
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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 | 157028
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License Number State | PA
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