Provider Demographics
NPI:1629892872
Name:RIVIERE BEHAVIORAL CARE
Entity type:Organization
Organization Name:RIVIERE BEHAVIORAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN-MERIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUAGHEU
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:978-551-1607
Mailing Address - Street 1:43 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1371
Mailing Address - Country:US
Mailing Address - Phone:978-551-1607
Mailing Address - Fax:
Practice Address - Street 1:43 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1371
Practice Address - Country:US
Practice Address - Phone:978-551-1607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)