Provider Demographics
NPI:1275839813
Name:RIVER HILL MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:RIVER HILL MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:V
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:240-678-6118
Mailing Address - Street 1:6030 DAYBREAK CIR
Mailing Address - Street 2:SUITE A150/341
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1642
Mailing Address - Country:US
Mailing Address - Phone:240-678-6118
Mailing Address - Fax:
Practice Address - Street 1:6030 DAYBREAK CIR
Practice Address - Street 2:SUITE A150/341
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1642
Practice Address - Country:US
Practice Address - Phone:240-678-6118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-30
Last Update Date:2011-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051608261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)