Provider Demographics
NPI:1053764456
Name:RIVER STONES CHILD AND ADOLESCENT TREATMENT
Entity type:Organization
Organization Name:RIVER STONES CHILD AND ADOLESCENT TREATMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-645-1820
Mailing Address - Street 1:PO BOX 7340
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375
Mailing Address - Country:US
Mailing Address - Phone:909-748-7141
Mailing Address - Fax:909-748-0582
Practice Address - Street 1:26967 BEAUMONT AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373
Practice Address - Country:US
Practice Address - Phone:909-748-7141
Practice Address - Fax:909-748-0582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness