MEDICARE: RIVER CITY RESIDENTIAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	320800000X	Mental Illness Community Based Residential Treatment Facility
2	251S00000X	Community/Behavioral Health Agency
3	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1508487901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER CITY RESIDENTIAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2549
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23058-2549
Country	:	US
Telephone Number	:	804-230-0999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2106 HUNGARY RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2208
Country	:	US
Telephone Number	:	804-230-0999
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	JAMES CHRISTMAS III
Credential	:	LCSW
Telephone Number	:	804-230-0999

Provider Enumeration Date	:	04/27/2020
Last Update Date	:	01/17/2026

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