Provider Demographics
NPI:1255064937
Name:RIVER STONES RTC
Entity type:Organization
Organization Name:RIVER STONES RTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-645-1820
Mailing Address - Street 1:PO BOX 7340
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-0340
Mailing Address - Country:US
Mailing Address - Phone:323-440-4536
Mailing Address - Fax:833-272-3431
Practice Address - Street 1:13628 SAN TIMOTEO CANYON RD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7815
Practice Address - Country:US
Practice Address - Phone:909-645-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children