Provider Demographics
NPI:1235825514
Name:RIVER OF HOPE BEHAVIORAL HEALTH AND WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:RIVER OF HOPE BEHAVIORAL HEALTH AND WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/PA
Authorized Official - Prefix:
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ISBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:309-229-8367
Mailing Address - Street 1:79 WOODFIN PL STE 212
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2492
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:79 WOODFIN PL STE 212
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2492
Practice Address - Country:US
Practice Address - Phone:309-229-8337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty