River'S Shore Clinic CTC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

227113 Issued in WI

Legal business name

RIVER'S SHORE CLINIC CTC

Practice address

3707 N Richards St
Milwaukee, WI 53212-1673

Phone

(414) 967-7006

NPI assigned

Jul 27, 2016

Organization subpart

No

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

Authorized official

Name

Lateka Washington

Title

Clinical Director

Phone

(414) 967-7006

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1285187179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N RICHARDS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121673",
            "telephone_number": "414-967-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 N RICHARDS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121673",
            "telephone_number": "414-967-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER'S SHORE CLINIC CTC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "LATEKA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "414-967-7006"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WI",
            "license": "227113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100056280",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane A Rivas
• Kali M Rivas, M.D.
• River West Home Care Assistant, LLC
• River'S Shore Clinic
• River'S Shore Clinic CTC
• Brenda Esmeralda Rivera Caro, RDN
• Gladys Rivera Hernandez
• Angelique Rivera
• Cecilia Rivera, R.N.
• Donnie Rivera, DDS

• Substance Abuse Rehabilitation Facility in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Substance Abuse Rehabilitation Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.