THE RIVER SOURCE OUTPATIENT PEORIA NPI 1295198497

NPI Information

THE RIVER SOURCE OUTPATIENT PEORIA is a rehabilitation and substance use disorder clinic center in Phoenix, AZ. THE RIVER SOURCE OUTPATIENT PEORIA NPI is 1295198497. The provider is registered as an organization entity type.

The provider's business location address is:

2432 W PEORIA AVE
SUITE 1227
PHOENIX, AZ
ZIP 85029-726
Phone: (623) 277-8385

The provider's authorized official is John Richards .
The authorized official title is Director Of Account Management and has the following contact phone number (561) 413-9860.

The enumeration date for this NPI number is 4/4/2016 and was last updated on 4/4/2016.

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:

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