The River Source Iop

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE RIVER SOURCE IOP

Practice address

128 W Pepper PL
Suite 126 & 128
Mesa, AZ 85201-7317

Phone

(480) 241-0170

Fax

(480) 610-3823

NPI assigned

Aug 4, 2015

Organization subpart

No

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

Authorized official

Name

Teresa Stenz, BHT

Title

Behavioral Health Insurance Coordin

Phone

(450) 241-0170

Specialties & licenses 1

Addresses

Tax ID family

The River Source Iop2 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 Iop LLC

  • Substance Abuse Rehabilitation Facility
  • Mesa, AZ
  • NPI 1538599469
  NPD tax ID

Locations

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1700262490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W PEPPER PL",
            "address_2": "SUITE 126 & 128",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017317",
            "telephone_number": "480-241-0170",
            "fax_number": "480-610-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W PEPPER PL",
            "address_2": "SUITE 126 & 128",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017317",
            "telephone_number": "480-241-0170",
            "fax_number": "480-610-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RIVER SOURCE IOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "STENZ",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH INSURANCE COORDIN",
        "authorized_official_telephone_number": "450-241-0170",
        "authorized_official_credential": "BHT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Renew Group LLC
• The Resolution Group, Inc.
• The Retina Group, PLLC
• The River of Life Counseling, LLC
• The River Source
• The River Source Iop LLC
• The Sleep and Wellness Doc LLC
• The Source Naturopathic Medical Clinic
• The Spine Docs, LLC (North Mesa Chiropractic)
• The Stone Community Health Center, LLC

• Substance Abuse Rehabilitation Facility in Mesa, AZ
• Providers in Mesa, 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 Aug 4, 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.