Provider Demographics
NPI:1508487901
Name:RIVER CITY RESIDENTIAL SERVICES, LLC
Entity Type:Organization
Organization Name:RIVER CITY RESIDENTIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTMAS
Authorized Official - Suffix:III
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-230-0999
Mailing Address - Street 1:PO BOX 2549
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23058-2549
Mailing Address - Country:US
Mailing Address - Phone:804-230-0999
Mailing Address - Fax:
Practice Address - Street 1:2106 HUNGARY RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2208
Practice Address - Country:US
Practice Address - Phone:804-230-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-27
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health