Riverside Treatment Services LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

RIVERSIDE TREATMENT SERVICES LLC

Practice address

8359 Pulaski Highway
Rosedale, MD 21237

Phone

(443) 841-2598

NPI assigned

Mar 21, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Charles Joseph Watson, LGSW

Title

Director

Phone

(443) 841-2598

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Opioid treatment program

Medicare-enrolled since Apr 28, 2020

Enrollment records 1

Locations

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1801258736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8359 PULASKI HIGHWAY",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "443-841-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 PULASKI HIGHWAY",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "443-841-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE TREATMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-841-2598",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LGSW"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genovia C Riley, LMSW
• Minette G. Rilloraza, CRNP
• Grace Mae Ritter, DVM
• Mileyni Rivera, LGPC
• Samantha Rivera, LMSW
• Jesse Robertson, LCSW-C
• Kyoko Rodrigues, LGPC
• Camila Rodriguez
• Angela Roelofs, LCSW-C
• Finny Rogers

• Methadone Clinic in Rosedale, MD
• Providers in Rosedale, MD by specialty
• Methadone Clinic in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.