Organization
THE RIVER SOURCE OUTPATIENT TUSCON
Active
Parent organization
THE RIVER SOURCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE RIVER SOURCE
Authorized official
JOHN RICHARDS (DIRECTOR OF ACCOUNT MANAGEMENT)
(561) 413-9860
Entity
Organization
Contact information
Practice address
6700 N ORACLE ROAD, SUITE 121, TUSCSON, AZ 85704-7733
(623) 277-8385
Mailing address
6700 N ORACLE ROAD, SUITE 121, TUSCSON, AZ 85704-7733
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
CSLG7586
AZ
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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