Provider Demographics
NPI:1700203601
Name:RIVERVIEW COMMUNITY MENTAL HEALTH CENTER LLC
Entity Type:Organization
Organization Name:RIVERVIEW COMMUNITY MENTAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:F
Authorized Official - Last Name:OLIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-266-4713
Mailing Address - Street 1:865 SE MONTEREY COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3337
Mailing Address - Country:US
Mailing Address - Phone:772-266-4713
Mailing Address - Fax:772-888-9082
Practice Address - Street 1:865 SE MONTEREY COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3337
Practice Address - Country:US
Practice Address - Phone:772-266-4713
Practice Address - Fax:772-872-6235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health