Provider Demographics
NPI:1649945627
Name:THE RIVERBEND GROUP LLC
Entity type:Organization
Organization Name:THE RIVERBEND GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-435-6563
Mailing Address - Street 1:11 RIVER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2036
Mailing Address - Country:US
Mailing Address - Phone:617-435-6563
Mailing Address - Fax:
Practice Address - Street 1:11 RIVER ST STE 2
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2036
Practice Address - Country:US
Practice Address - Phone:617-435-6563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty