Provider Demographics
NPI:1225525553
Name:RIVERBEND COMMUNITY MENTAL HEALTH, INC
Entity Type:Organization
Organization Name:RIVERBEND COMMUNITY MENTAL HEALTH, INC
Other - Org Name:RIVERBEND LABORATORY
Other - Org Type:Other Name
Authorized Official - Title/Position:VP-HR
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:CORWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-226-7505
Mailing Address - Street 1:PO BOX 2032
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302-2032
Mailing Address - Country:US
Mailing Address - Phone:603-226-7505
Mailing Address - Fax:603-225-2803
Practice Address - Street 1:40 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4006
Practice Address - Country:US
Practice Address - Phone:603-226-7505
Practice Address - Fax:603-225-2803
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERBEND COMMUNITY MENTAL HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-23
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH30D2116758291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory