Provider Demographics
NPI:1912931023
Name:RIVERSIDE CARE INC
Entity Type:Organization
Organization Name:RIVERSIDE CARE INC
Other - Org Name:CONTINUUM INC D/B/A RIVERSIDE CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'ROURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-635-7438
Mailing Address - Street 1:100 EAGLEVILLE ROAD
Mailing Address - Street 2:PO BOX 220
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19408-0220
Mailing Address - Country:US
Mailing Address - Phone:610-635-7445
Mailing Address - Fax:610-635-7627
Practice Address - Street 1:31 SOUTH 10TH AVENUE
Practice Address - Street 2:SUITE 6
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-383-9600
Practice Address - Fax:610-383-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA157028261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007578550025Medicaid
PA1007578550025Medicaid