Organization
RIVERSIDE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA BOYD (BUSINESS OFFICE MANAGER)
(208) 746-4097
Entity
Organization
Contact information
Practice address
155 MAIN STREET, OROFINO, ID 83544-2287
(208) 476-9393
(208) 476-7932
Mailing address
1720 18TH AVE, PO BOX 2287, LEWISTON, ID 83501-4047
(208) 746-4097
(208) 746-2294
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
138
ID
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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