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NPI Code Detail

MEDICARE: RIVERWOOD MENTAL HEALTH SERVICES

MEDICARE: RIVERWOOD MENTAL HEALTH SERVICES
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
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment FacilityL-9010RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366501603
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERWOOD MENTAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 25 RAILROAD AVE
Second Line : PO BOX 226
City : WARREN
State : RI
Zip : 02885-3206
Country : US
Telephone Number : 401-247-4278
Fax Number :
Provider Business Practice Location Address
First Line : 25 RAILROAD AVE
Second Line :
City : WARREN
State : RI
Zip : 02885-3206
Country : US
Telephone Number : 401-247-4278
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DANIEL J KUBAS-MEYER
Credential :
Telephone Number : 401-247-4278
Provider Enumeration Date : 12/06/2006
Last Update Date : 08/22/2020

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Directions to “RIVERWOOD MENTAL HEALTH SERVICES ” Practice Location

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