# RIVERSIDE MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE MEDICAL CENTER
- **Other names:** Crisis Residential Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558774869
- **Legal business name:** RIVERSIDE MEDICAL CENTER
- **Authorized official:** MR. BILL W DOUGLAS (VICE PRESIDENT AND CFO)
- **Authorized official phone:** (815) 935-7256

## Contact information

- **Practice address:** 260 S WASHINGTON AVE, KANKAKEE, IL 60901-3729
- **Practice address phone:** (815) 935-7256
- **Practice address fax:** (815) 935-7490
- **Mailing address:** 350 N WALL ST, KANKAKEE, IL 60901-2901
- **Mailing address phone:** (815) 935-7256
- **Mailing address fax:** (815) 935-7490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 0002014 | IL | Yes |

## Other

- **Enumeration date:** 06/04/2014
- **Last updated:** 06/04/2014