# RIVER CITY REHABILITATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083607220
- **Authorized official:** MS. GINA L ASHFORD (MANAGER)
- **Authorized official phone:** (662) 335-8332

## Contact information

- **Practice address:** 1707 SOUTH COLORADO, SUITE A, GREENVILLE, MS 38703
- **Practice address phone:** (662) 335-8332
- **Practice address fax:** (662) 335-8852
- **Mailing address:** 1707 SOUTH COLORADO, SUITE A, GREENVILLE, MS 38703
- **Mailing address phone:** (662) 335-8332
- **Mailing address fax:** (662) 335-8852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT1045 | MS | Yes |
| 225X00000X | Occupational Therapist | OT0169 | MS | — |

## Other

- **Enumeration date:** 08/23/2005
- **Last updated:** 07/07/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09015486 | — | MS |