Provider Demographics
NPI:1306387923
Name:RIVER COUNSELING LLC
Entity Type:Organization
Organization Name:RIVER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:THRESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-699-9138
Mailing Address - Street 1:PO BOX 1144
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33871-1144
Mailing Address - Country:US
Mailing Address - Phone:813-699-9138
Mailing Address - Fax:877-770-2109
Practice Address - Street 1:1647 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-7938
Practice Address - Country:US
Practice Address - Phone:813-699-9138
Practice Address - Fax:877-770-2109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable