THE RIVER SOURCE OUTPATIENT PEORIA (NPI# 1295198497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295198497 |
| Entity Type | Organization |
| Organization Name | THE RIVER SOURCE OUTPATIENT PEORIA |
| Practice Address |
2432 W Peoria Ave Suite 1227 Phoenix AZ 85029-4726 |
| Mailing Address |
2432 W Peoria Ave Suite 1227 Phoenix AZ 85029-4737 |
| Practice Telephone | 6232778385 |
| Mailing Telephone | 6232778385 |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | JOHN RICHARDS (DIRECTOR OF ACCOUNT MANAGEMENT) |
| Authorized Official Telephone | 5614139860 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
CSLG7631 | AZ | Ambulatory Health Care Facilities |
| Street Address |
2432 W PEORIA AVE SUITE 1227 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85029-4726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063497725 | Rosemarie Ludwig | Counselor | 2432 W Peoria Ave, Ste 1002, Phoenix, AZ 85029-4727 | 2005-12-14 |
| 1770123614 | Supportive Community Services LLC | Counselor | 2432 W Peoria Ave, Phoenix, AZ 85029-4726 | 2020-01-08 |
| 1265789416 | Phoenix Toxicology and Lab Services, LLC | Clinical Medical Laboratory | 2432 W Peoria Ave, Suite 1064, Phoenix, AZ 85029-4726 | 2012-08-07 |
| 1255623260 | Marvah D'aquino | Specialist/Technologist | 2432 W Peoria Ave, Suite 1044, Phoenix, AZ 85029-4726 | 2011-05-10 |
| 1801185152 | Marissa Elena Hernandez | Specialist/Technologist | 2432 W Peoria Ave, Phoenix, AZ 85029-4726 | 2011-04-06 |
| 1518265404 | Suzette Bernales | Specialist/Technologist | 2432 W Peoria Ave, Suite 1044, Phoenix, AZ 85029-4726 | 2011-03-02 |
| 1720211402 | Anna Kay Lee | Specialist/Technologist | 2432 W Peoria Ave, Phoenix, AZ 85029-4726 | 2009-08-28 |
| 1568604445 | Muinat Adepeju Udoinwang | Home Health | 2432 W Peoria Ave, Building 5 Suite 1120, Phoenix, AZ 85029-4726 | 2009-03-24 |
| 1073758835 | Quality Transport Services of Az | Non-emergency Medical Transport (VAN) | 2432 W Peoria Ave, #1340, Phoenix, AZ 85029 | 2008-12-09 |
| 1649438821 | Michael L Rinker | Counselor | 2432 W Peoria Ave, 1187, Phoenix, AZ 85029-4726 | 2008-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153799 | Haydee Bermudez | Counselor | 3301 North 33rd Ave., Phoenix, AZ 85029 | 2020-10-27 |
| 1871191221 | Covenant Home Health LLC | In Home Supportive Care | 11830 N. 19th Ave, Suite 101 Pendleton, Phoenix, AZ 85029 | 2020-10-16 |
| 1508406745 | Tailored 2 U Psychiatry, Pllc | Nurse Practitioner | 4150 W Peoria Avenue, Suite 116, Phoenix, AZ 85029 | 2020-01-15 |
| 1770125403 | Desert Gem Assisted Living Facility, LLC | Custodial Care Facility | 3236 W. Eugie Avenue, Phoenix, AZ 85029 | 2019-10-15 |
| 1588128623 | Anna Debbs | Counselor | 11221 North 28th Drive, Bldg E, Phoenix, AZ 85029 | 2019-01-23 |
| 1609360007 | Melissa Lynn Denton | Specialist/Technologist | 4014 W Paradise Dr, Phoenix, AZ 85029 | 2018-06-19 |
| 1275038713 | Jamilah Amirah | Behavioral Analyst | 11024 N 28th Dr Ste 110, Phoenix, AZ 85029 | 2018-03-27 |
| 1639687056 | Empower Home Care, LLC. | Home Health | 11225 N 28th Drive, Suite D115e, Phoenix, AZ 85029 | 2018-01-19 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1073966347 | Meka Joi Green | Social Worker | 11225 M 28th Dr, Suite C210, Phoenix, AZ 85029 | 2016-07-21 |
| Find all providers in zip 85029 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124662788 | Jh Medical Services LLC | Clinic/Center | 4635 W Mcdowell Rd Ste 110, Phoenix, AZ 85035-4149 | 2019-11-06 |
| 1174185680 | Vogue Recovery Arizona | Clinic/Center | 4122 N 17th St Ste A, Phoenix, AZ 85016-5922 | 2019-07-04 |
| 1891350955 | Lett, Rohde, & Walling, PC | Clinic/Center | 3839 E Shea Blvd, Phoenix, AZ 85028-3445 | 2019-05-04 |
| 1982171302 | Terros, Inc | Clinic/Center | 4616 N 51st Ave Ste 201, Phoenix, AZ 85031-1716 | 2018-10-24 |
| 1417982810 | Valley Hope Association | Clinic/Center | 3233 Peoria Ave, Ste 203, Phoenix, AZ 85029-4615 | 2006-07-12 |
| 1437115367 | Lett, Rohde, & Walling, PC | Clinic/Center | 4222 E Camelback Rd Ste 230h, Phoenix, AZ 85018-2787 | 2006-04-20 |
| 1043838535 | Global Family Care Behavioral Health Home LLC | Clinic/Center | 18006 N 6th Dr, Phoenix, AZ 85023-6489 | 2020-07-10 |
| 1255962270 | Crossroads, Inc | Clinic/Center | 3702 N 13th Ave, Phoenix, AZ 85013-3677 | 2020-01-29 |
| 1265079560 | Hushabye Nursery | Clinic/Center | 3003 E Mcdowell Rd, Phoenix, AZ 85008-3620 | 2019-12-05 |
| 1972070399 | Terros, Inc | Clinic/Center | 8836 N 23rd Ave Ste B1, Phoenix, AZ 85021-4175 | 2018-10-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.