The River Source

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

13-1381 Issued in AZ

Legal business name

THE RIVER SOURCE

Practice address

950 N Arizola Rd Ste 3
Casa Grande, AZ 85122-6196

Phone

(520) 836-2205

Fax

(520) 836-1882

NPI assigned

May 24, 2014

Organization subpart

No

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

Authorized official

Name

Daryl Ferrell

Title

Executive Director

Phone

(520) 836-2205

Specialties & licenses 1

Addresses

Tax ID family

The River Source2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The River Source

  • Substance Abuse Rehabilitation Facility
  • Mesa, AZ
  • NPI 1336454867
  NPD tax ID

Locations

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400889600000",
    "number": "1497167480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N ARIZOLA RD STE 3",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226196",
            "telephone_number": "520-836-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N ARIZOLA RD STE 3",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226196",
            "telephone_number": "520-836-2205",
            "fax_number": "520-836-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RIVER SOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-24",
        "last_updated": "2014-05-24",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "520-836-2205"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "13-1381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime R, Testa, MD
• Andrew S Thatcher, PHARMD
• The Garnet at Casa Grande
• The Heritage at Palm Parke LLC (The Heritage Living)
• The Hip Group, LLC (Maricopa Hearing Center)
• Therapeeps, LLC
• Corey Richard Therrien, COTA/L
• Kassondra Dawn Thomason, COTA/L
• April Yvonne Thompson, PHARM D
• Tuesday Thompson

• Substance Abuse Rehabilitation Facility in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2014; 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.