Provider Demographics
NPI:1104687474
Name:RIVYVE BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:RIVYVE BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LUCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-236-4611
Mailing Address - Street 1:2150 SILVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-8472
Mailing Address - Country:US
Mailing Address - Phone:623-236-4611
Mailing Address - Fax:928-299-2906
Practice Address - Street 1:3131 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-0951
Practice Address - Country:US
Practice Address - Phone:623-236-4611
Practice Address - Fax:928-299-2096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVYVE BEHAVIORAL HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility