Provider Demographics
NPI:1154563351
Name:RIVERSIDE COMMUNITY CARE
Entity type:Organization
Organization Name:RIVERSIDE COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:781-247-7764
Mailing Address - Street 1:385 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6578
Mailing Address - Country:US
Mailing Address - Phone:508-887-6424
Mailing Address - Fax:
Practice Address - Street 1:385 GRANT ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6578
Practice Address - Country:US
Practice Address - Phone:508-887-6424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health