Provider Demographics
NPI:1366965485
Name:RIVERBEND BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:RIVERBEND BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:SARGENT-SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-318-5684
Mailing Address - Street 1:701 N NILES AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-1923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 N NILES AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-1923
Practice Address - Country:US
Practice Address - Phone:574-318-5684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children