River Ridge, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

RIVER RIDGE, LLC

Doing business as

River Ridge LLC Four Seasons Outpatient

Practice address

4205 Lancaster LN N Ste 101
Plymouth, MN 55441-1702

Phone

(952) 894-7722

Fax

(952) 894-0882

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Patricia Patche, MA

Title

Cfo

Phone

(952) 564-3000

Specialties & licenses 3

Addresses

Other names 1

• River Ridge LLC Four Seasons Outpatient Doing business as

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

  • Addiction (Substance Use Disorder) Counselor
  • Burnsville, MN
  • NPI 1164891776
  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": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1295105906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W TRAVELERS TRL",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372553",
            "telephone_number": "952-894-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N STE 101",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411702",
            "telephone_number": "952-894-7722",
            "fax_number": "952-894-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "PATCHE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "952-564-3000",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Ridge LLC Four Seasons Outpatient",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Lawrence Rieck
• Rachel Riley, PHARMD
• Steven I Riley, PT
• Darcy Risbrudt
• Ryan McCauley Rivard
• RJ's Home Health Care, LLC
• Andre Roberson
• Erica N. Roberson, M.D.
• Cody Gray Roberts, MD
• Julia Roberts, DPT

• Substance Use Disorder Rehabilitation Clinic/Center in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.