RIVERSIDE PSYCHIATRIC SERVICES PLLC NPI 1114761186

NPI Information

  • NPI: 1114761186
  • Provider Name: RIVERSIDE PSYCHIATRIC SERVICES PLLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 2180 44TH ST SE STE 107
    GRAND RAPIDS, MI
    ZIP 49508
  • Phone: (616) 425-9666

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NPI Details

RIVERSIDE PSYCHIATRIC SERVICES PLLC is a psychiatric/mental health nurse practitioner in Grand Rapids, MI. RIVERSIDE PSYCHIATRIC SERVICES PLLC NPI is 1114761186. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2180 44TH ST SE STE 107
GRAND RAPIDS, MI
ZIP 49508-305
Phone: (616) 425-9666

The provider's authorized official is Godfrey Abuya .
The authorized official title is Manager and has the following contact phone number (616) 334-0011.

The enumeration date for this NPI number is 6/24/2024 and was last updated on 5/14/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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