Provider Demographics
NPI:1083380364
Name:RILEY THERAPEUTIC SERVICES INC
Entity Type:Organization
Organization Name:RILEY THERAPEUTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-450-5265
Mailing Address - Street 1:42 EDWARDS ST STE A
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-1937
Mailing Address - Country:US
Mailing Address - Phone:774-450-5265
Mailing Address - Fax:
Practice Address - Street 1:42 EDWARDS ST STE A
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-1937
Practice Address - Country:US
Practice Address - Phone:774-450-5265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty