Provider Demographics
NPI:1083264022
Name:RIVER HEALTH & WELLNESS, LLC.
Entity Type:Organization
Organization Name:RIVER HEALTH & WELLNESS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-260-1655
Mailing Address - Street 1:35671 KENAI SPUR HWY
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7627
Mailing Address - Country:US
Mailing Address - Phone:907-260-1655
Mailing Address - Fax:855-854-8577
Practice Address - Street 1:35671 KENAI SPUR HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7627
Practice Address - Country:US
Practice Address - Phone:907-260-1655
Practice Address - Fax:855-854-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care