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Organization

RIVERSIDE COMMUNITY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA M COSTIGAN (JAIL DIVERSION CLINICIAN)
(401) 258-1621
Entity
Organization

Contact information

Practice address
34 POTTER ST, PAWTUCKET, RI 02860-4222
(401) 258-1621
Mailing address
34 POTTER ST, PAWTUCKET, RI 02860-4222
(401) 258-1621

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
05/25/2011
Last updated
05/25/2011
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