River Ridge, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

RIVER RIDGE, LLC

Practice address

14750 Lac Lavon Dr
Burnsville, MN 55306-6398

Phone

(952) 894-7722

NPI assigned

Sep 24, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Brian P Sammon, MA, LMFT, LADC

Title

President

Phone

(952) 564-3000

Specialties & licenses 1

Addresses

Other names 1

• River Ridge, LLC-Burnsville outpatient Other name

Tax ID family

River Ridge LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• River Ridge, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Plymouth, MN
  • NPI 1295105906
  NPD tax ID
• River Ridge, LLC

  • Substance Abuse Rehabilitation Facility
  • Burnsville, MN
  • NPI 1669842373
  NPD tax ID
• River Ridge, LLC

  • Substance Abuse Rehabilitation Facility
  • Burnsville, MN
  • NPI 1922478619
  NPD tax ID

Locations

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1164891776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W BURNSVILLE PKWY",
            "address_2": "SUITE 103",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372524",
            "telephone_number": "952-894-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14750 LAC LAVON DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066398",
            "telephone_number": "952-894-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "SAMMON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-564-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LMFT, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Ridge, LLC-Burnsville outpatient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kyla Shaunta Riley
• Maylisha Ann Riley
• Brianna Ripoli, LPCC, LADC
• Rise With Dignity
• Rise With Dignity
• River Ridge, LLC
• River Ridge, LLC
• Seville Kierra Rivera
• Kailianna Rivet
• Robert T. Thiry

• Addiction (Substance Use Disorder) Counselor in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.