Riverside Service Group Inc

LBN: Riverside Service Group Inc
Riverside Service Group Inc is an health care organization with primary practice located at 461 River Pkwy , Idaho Falls ID 83402-3314. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Agencies / Day Training, Developmentally Disabled Services. Agencies / Day Training, Developmentally Disabled Services is the primary health care specialty. Riverside Service Group Inc can be contacted via phone (208) 542-4517, or through Hansen, Kathleen Ann via phone (208) 521-6573.

Contact Information

Primary practice address
461 River Pkwy Idaho Falls ID 83402-3314
Fax: (208) 528-9501
Website:
Authorized official contact:
Name: Hansen, Kathleen Ann

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X 807612600 Idaho
Agencies / Day Training, Developmentally Disabled Services 251C00000X 805608500 Idaho

Profile Details

NPI number 1346390796
LBN Legal business name Riverside Service Group Inc
DBA Doing business as
Authorized official Hansen, Kathleen Ann
Entity Organization
Organization subpart 1 No
Enumeration date Jan 10th, 2007
Last updated Jun 25th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346390796 NPPES
Idaho MEDICAID 805608500
Idaho MEDICAID 807612600

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