Provider Demographics
NPI:1033588173
Name:RILEY CENTER FOR EATING DISORDERS, LLC
Entity Type:Organization
Organization Name:RILEY CENTER FOR EATING DISORDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-CP, CEDS
Authorized Official - Phone:864-271-0975
Mailing Address - Street 1:12 MAPLE TREE CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4078
Mailing Address - Country:US
Mailing Address - Phone:864-271-0975
Mailing Address - Fax:864-241-9001
Practice Address - Street 1:12 MAPLE TREE CT
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4078
Practice Address - Country:US
Practice Address - Phone:864-271-0975
Practice Address - Fax:864-241-9001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RILEY THERAPY, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty