Provider Demographics
NPI:1336760644
Name:RIVER STONES RESIDENTIAL TREATMENT SERVICES INC
Entity Type:Organization
Organization Name:RIVER STONES RESIDENTIAL TREATMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-748-7141
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:909-748-7141
Mailing Address - Fax:833-272-3431
Practice Address - Street 1:1020 CORONADO DR
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-6293
Practice Address - Country:US
Practice Address - Phone:909-748-7141
Practice Address - Fax:833-272-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children