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Organization
RIVERSIDE RECOVERY LLC
Active
Organization
RIVERSIDE RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA LIGHT BENNETT (OWNER)
(208) 746-4097
Entity
Organization
Contact information
Practice address
1720 18TH AVE, LEWISTON, ID 83501-4047
(208) 746-4097
(208) 746-2294
Mailing address
1720 18TH AVE, LEWISTON, ID 83501-4047
(208) 746-4097
(208) 746-2294
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCPC-2714
ID
101YM0800X
Mental Health Counselor
LCPC-5714
ID
104100000X
Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/21/2015
Last updated
12/16/2025
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