Organization
THE RIVER SOURCE
Active
Organization
THE RIVER SOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP WESTBROOKS (PRESIDENT AND CEO)
(480) 206-3999
Entity
Organization
Contact information
Practice address
108 E 2ND AVE, MESA, AZ 85210-1410
(888) 687-7332
(480) 827-1637
Mailing address
108 E 2ND AVE, MESA, AZ 85210-1410
(888) 687-7332
(480) 827-1637
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH-3428
AZ
Other
Enumeration date
08/09/2010
Last updated
01/18/2017
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