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NPI Code Detail

MEDICARE: RIVER VALLEY BEHAVIORAL HEALTH & WELLNESS CENTER, PLLC

MEDICARE: RIVER VALLEY BEHAVIORAL HEALTH & WELLNESS CENTER, PLLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist

General Provider Information

NPI Number : 1316197148
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER VALLEY BEHAVIORAL HEALTH & WELLNESS CENTER, PLLC
Provider Business Mailing Address
First Line : 8640 EAGLE CREEK CIR
Second Line :
City : SAVAGE
State : MN
Zip : 55378-4400
Country : US
Telephone Number : 952-746-7664
Fax Number :
Provider Business Practice Location Address
First Line : 8640 EAGLE CREEK CIR
Second Line :
City : SAVAGE
State : MN
Zip : 55378-4400
Country : US
Telephone Number : 952-746-7664
Fax Number :
Authorized Official
Title or Position : CLINIC MANAGER
Name : SARA KUESTER
Credential :
Telephone Number : 952-746-7664
Provider Enumeration Date : 09/29/2008
Last Update Date : 12/11/2023

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