| Integrated Healthcare Systems Riviera Inc | |
|
31 W 20th St Riviera Beach FL 33404-6155 | |
| (561) 510-0471 | |
| (561) 331-2715 |
| Full Name | Integrated Healthcare Systems Riviera Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 31 W 20th St, Riviera Beach, Florida |
| Authorized Official Name and Position | Monique D Brown Faust (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5618999140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Healthcare Systems Riviera Inc 31 W 20th St Riviera Beach FL 33404-6155 Ph: (561) 510-0471 | Integrated Healthcare Systems Riviera Inc 31 W 20th St Riviera Beach FL 33404-6155 Ph: (561) 510-0471 |
| NPI Number | 1841812021 |
|---|---|
| Provider Enumeration Date | 05/11/2020 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Medicare PECOS PAC ID | 0840613360 |
|---|---|
| Medicare Enrollment ID | O20200630003396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841812021 | NPI | - | NPPES |
| Provider Name | Roosevelt T Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295951374 PECOS PAC ID: 8729169081 Enrollment ID: I20200422002474 |
| Provider Name | Shanice Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689276396 PECOS PAC ID: 6709274509 Enrollment ID: I20211028000156 |
| Provider Name | Monique D Brown Faust |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164762696 PECOS PAC ID: 1355650722 Enrollment ID: I20240206004954 |
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