RIVERSIDE SERVICE GROUP INC (NPI# 1346390796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346390796 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE SERVICE GROUP INC |
| Practice Address |
461 River Pkwy Idaho Falls ID 83402-3314 |
| Mailing Address |
3925 N Ammon Rd Idaho Falls ID 83401-1313 |
| Practice Telephone | 2085424517 |
| Practice Fax Number | 2085289501 |
| Mailing Telephone | 2085216573 |
| Mailing Fax Number | 2085289501 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2010-06-25 |
| Authorized Official Name | MRS. KATHLEEN ANN HANSEN (PRESIDENT CEO) |
| Authorized Official Telephone | 2085216573 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | 807612600 | ID | Other Service Providers |
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 805608500 | ID | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807612600 | 05 | |
| ID | 805608500 | 05 |
| Street Address |
461 RIVER PKWY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932306826 | Teleios Consulting Services Inc | Day Training, Developmentally Disabled Services | 445 N Capital Ave Ste 8, Idaho Falls, ID 83402-3652 | 2007-07-02 |
| 1104948322 | Development Workshop, Inc. | Day Training, Developmentally Disabled Services | 555 W 25th St, Idaho Falls, ID 83402-4527 | 2007-04-06 |
| 1851415129 | Affiliates Inc. | Day Training, Developmentally Disabled Services | 265 Gladstone St, Idaho Falls, ID 83401-2511 | 2007-03-19 |
| 1255473203 | Joshua D. Smith Foundation | Day Training, Developmentally Disabled Services | 756 Oxford Dr, Idaho Falls, ID 83401-4233 | 2007-02-13 |
| 1487791364 | Transitions, Inc. | Day Training, Developmentally Disabled Services | 520 Lomax St, Idaho Falls, ID 83401-2634 | 2007-01-31 |
| 1841343274 | Options Inc. | Day Training, Developmentally Disabled Services | 220 Ash St, Idaho Falls, ID 83402-4041 | 2007-01-19 |
| 1700198041 | Life Improvement Center, LLC | Day Training, Developmentally Disabled Services | 2420 E 25th St, Suite C, Idaho Falls, ID 83404-7549 | 2010-07-01 |
| 1871639674 | Home-link Trust Inc | Day Training, Developmentally Disabled Services | 211 S Woodruff Ave, Suite F, Idaho Falls, ID 83401-4369 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477086114 | Teton Supported Living LLC | Day Training, Developmentally Disabled Services | 4101 N Creswell Way, Boise, ID 83713-2404 | 2017-04-10 |
| 1962889055 | Community Connections South Central | Day Training, Developmentally Disabled Services | 212 2nd Ave W, #102 & 104, Twin Falls, ID 83301-6016 | 2015-04-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1902205230 | Andrea Loban | Day Training, Developmentally Disabled Services | 5049 Fox Creek Hollow, Victor, ID 83455-0000 | 2014-08-22 |
| 1336570118 | Independent Living Specialists, LLC | Day Training, Developmentally Disabled Services | 379 Yellowstone Ave, Pocatello, ID 83201-4529 | 2013-12-04 |
| 1871935064 | Community Connections North, Inc. | Day Training, Developmentally Disabled Services | 1230 N Northwood Center Ct, Suite A, Coeur D Alene, ID 83814-4941 | 2013-07-29 |
| 1851734107 | Foundations for Independence LLC | Day Training, Developmentally Disabled Services | 2316 N Cole Rd Ste C, Boise, ID 83704-7365 | 2013-04-16 |
| 1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
| 1457694176 | A Plus Solutions Center | Day Training, Developmentally Disabled Services | 2311 Park Ave, Unit 3, Suite 12, Burley, ID 83318-2104 | 2013-04-01 |
| 1518208966 | Learning Garden Developmental Preschool | Day Training, Developmentally Disabled Services | 412 E Mullan Ave, Post Falls, ID 83854-7641 | 2013-03-11 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
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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.