NPIMap

Organization Active NPI

Riverside Rehab Inc

  • Community/Behavioral Health Agency
  • Boise, ID
National Provider Identifier
1912244732
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RIVERSIDE REHAB INC
Practice address
7711 W Riverside Dr
Boise, ID 83714-6182
Phone
(208) 853-8536
Fax
(208) 853-2929
NPI assigned
Jan 14, 2013
Last updated
Jan 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Mr. Leroy Hershel Barton, M.ED., CRC
Title
Owner
Phone
(208) 853-8536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

7711 W Riverside Dr
Boise, ID 83714-6182

Mailing address

7711 W Riverside Dr
Boise, ID 83714-6182
Phone (208) 853-8536

Other names 1

  • Riverside Rehab Group Other name

National Provider Directory

National Provider Directory
Tax ID family
Riverside Rehab3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1912244732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 W RIVERSIDE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837146182",
            "telephone_number": "208-853-8536",
            "fax_number": "208-853-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 W RIVERSIDE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837146182",
            "telephone_number": "208-853-8536",
            "fax_number": "208-853-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "HERSHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-853-8536",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED., CRC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Rehab Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.