Riverside Behavioral Health

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

801081083 Issued in MS

Legal business name

RIVERSIDE BEHAVIORAL HEALTH

Practice address

4618 S 31St West Ave
Tulsa, OK 74107-7532

Phone

(662) 419-9786

NPI assigned

Feb 25, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Grey McKellar, LSW

Title

Clinincal and Outpatient Director

Phone

(918) 855-2031

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1144527227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 S 31ST WEST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741077532",
            "telephone_number": "662-419-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 S 31ST WEST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741077532",
            "telephone_number": "662-419-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "MCKELLAR",
        "authorized_official_first_name": "GREY",
        "authorized_official_title_or_position": "CLININCAL AND OUTPATIENT DIRECTOR",
        "authorized_official_telephone_number": "918-855-2031",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "MS",
            "license": "801081083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Michael Rivera
• Marcos Rivero
• Noah Rivero
• Sara Marie Rivero, LPC
• Raechel Rivers
• Riverside Counseling Services
• Rivertree Senior Mental Health PLLC
• Rives Ventures
• Michelle Jean Rix, MHR
• Mina Rizwan, MD

• Psychiatric Residential Treatment Facility in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Psychiatric Residential Treatment Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.