Provider Demographics
NPI:1952944522
Name:RIVERBEND INTEGRATIVE TRAUMA TREATMENT
Entity Type:Organization
Organization Name:RIVERBEND INTEGRATIVE TRAUMA TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIANN
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:SANTAMARIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:434-249-1304
Mailing Address - Street 1:1120 SNOWDEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1297
Mailing Address - Country:US
Mailing Address - Phone:434-249-1304
Mailing Address - Fax:
Practice Address - Street 1:172 S PANTOPS DR STE C
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8672
Practice Address - Country:US
Practice Address - Phone:434-961-2555
Practice Address - Fax:434-961-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty