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General NPI Number Information
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NPI Number | 1972146165
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Entity Type | Organization
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Legal Business Name | RIVYVE BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 10/21/2019
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 2150 SILVER CREEK RD
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-8472
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Country | US
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Telephone | 928-718-4483
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Fax |
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Provider Business Mailing Address
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Address Line | 1099 E SUNRISE AVE
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City | KINGMAN
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State | AZ
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Zip | 86401-6825
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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 | CFO / TREASURER
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Name | MR. VANCE MILLER
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Credential |
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Telephone | 928-718-4483
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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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