MEDICARE: RIVERVALLEY BEHAVIORAL HEALTH INC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QD1600X	Developmental Disabilities Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	800003	KY
4	261QC1500X	Community Health Clinic/Center

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1285689711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVALLEY BEHAVIORAL HEALTH INC

Provider Business Mailing Address
First Line	:	P.O. BOX 1637
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42302
Country	:	US
Telephone Number	:	270-689-6500
Fax Number	:	270-689-6677

Provider Business Practice Location Address
First Line	:	1100 WALNUT ST
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-2956
Country	:	US
Telephone Number	:	270-689-6500
Fax Number	:	270-689-6500

Authorized Official
Title or Position	:	CFO
Name	:	MR. ERIC HICKS
Credential	:
Telephone Number	:	270-689-6540

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	12/05/2025

1202 FREDERICA STREET
OWENSBORO, KY
42301-2956

Practice Phone: 270-903-9003
Practice Fax: