Provider Demographics
NPI:1417982919
Name:RIVERSIDE CARE, INC
Entity Type:Organization
Organization Name:RIVERSIDE CARE, INC
Other - Org Name:CONTINUUM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SOLOMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-451-7000
Mailing Address - Street 1:499 N 5TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-4005
Mailing Address - Country:US
Mailing Address - Phone:215-451-7000
Mailing Address - Fax:215-925-6897
Practice Address - Street 1:6 SO. 3RD ST
Practice Address - Street 2:SUITE 508
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3543
Practice Address - Country:US
Practice Address - Phone:610-253-6760
Practice Address - Fax:610-868-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA487032261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100757855-0031Medicaid
PA1007578550034Medicaid
PA1007578550039Medicaid