Provider Demographics
NPI:1861432676
Name:RIVERSIDE TREATMENT SERVICES,INC
Entity type:Organization
Organization Name:RIVERSIDE TREATMENT SERVICES,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:AARTI
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBRAMANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-333-9355
Mailing Address - Street 1:4460 MACARTHUR BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2516
Mailing Address - Country:US
Mailing Address - Phone:202-333-9355
Mailing Address - Fax:202-333-7926
Practice Address - Street 1:4460 MACARTHUR BLVD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2516
Practice Address - Country:US
Practice Address - Phone:202-333-9355
Practice Address - Fax:202-333-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHFD01-0222283Q00000X, 323P00000X
DC3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered283Q00000XHospitalsPsychiatric Hospital
Not Answered323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Not Answered3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0207209Medicaid
VA4940067Medicaid
VA0207209Medicaid