Provider Demographics
NPI:1689863342
Name:RIVERBEND COMMUNITY MENTAL HEALTH, INC
Entity Type:Organization
Organization Name:RIVERBEND COMMUNITY MENTAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP-HR
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:CORWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-226-7505
Mailing Address - Street 1:PO BOX 2032
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302-2032
Mailing Address - Country:US
Mailing Address - Phone:603-226-7505
Mailing Address - Fax:
Practice Address - Street 1:3 NORTH STATE STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-226-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH41263521Medicaid
NH41263521Medicaid