Provider Demographics
NPI:1841872769
Name:ROCKSIDE, INC.
Entity type:Organization
Organization Name:ROCKSIDE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-467-4044
Mailing Address - Street 1:2421 N STATE HIGHWAY 3
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:CA
Mailing Address - Zip Code:96027-9579
Mailing Address - Country:US
Mailing Address - Phone:530-467-4044
Mailing Address - Fax:
Practice Address - Street 1:2421 N STATE HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:CA
Practice Address - Zip Code:96027-9579
Practice Address - Country:US
Practice Address - Phone:530-467-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility