RIVER RIDGE LLC NPI 1295105906

NPI Information

NPI: 1295105906
Provider Name: RIVER RIDGE, LLC
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
Doing Business As: RIVER RIDGE LLC FOUR SEASONS OUTPATIENT
CLIA Number: 24D0907487
Address: 4205 LANCASTER LN N STE 101
PLYMOUTH, MN
ZIP 55441
Phone: (952) 894-7722

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NPI Details

RIVER RIDGE, LLC is a rehabilitation and substance use disorder clinic center in Plymouth, MN. RIVER RIDGE, LLC NPI is 1295105906. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As River Ridge Llc Four Seasons Outpatient.

The provider's business location address is:

4205 LANCASTER LN N STE 101
PLYMOUTH, MN
ZIP 55441-702
Phone: (952) 894-7722
Fax: (952) 894-0882

The provider's authorized official is Patricia Patche .
The authorized official title is Cfo and has the following contact phone number (952) 564-3000.

The CLIA number assigned to this NPI record is 24D0907487 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/7/2015 and was last updated on 7/19/2022.

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	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes

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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