Provider Demographics
NPI:1497884035
Name:RIVERSIDE INDUSTRIES, INC
Entity Type:Organization
Organization Name:RIVERSIDE INDUSTRIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BITTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-527-2711
Mailing Address - Street 1:1 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1672
Mailing Address - Country:US
Mailing Address - Phone:413-527-2711
Mailing Address - Fax:413-529-9715
Practice Address - Street 1:1 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1672
Practice Address - Country:US
Practice Address - Phone:413-527-2711
Practice Address - Fax:413-529-9715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303392Medicaid