| Riverside Therapy Llc | |
|
250 Cushman St Ste 4f Fairbanks AK 99701-4665 | |
| (907) 987-5088 | |
| Not Available |
| Full Name | Riverside Therapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 250 Cushman St Ste 4f, Fairbanks, Alaska |
| Authorized Official Name and Position | Jennifer Lynn Tanner (OWNER) |
| Authorized Official Contact | 9079875088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Therapy Llc 250 Cushman St Ste 4f Fairbanks AK 99701-4665 Ph: (907) 987-5088 | Riverside Therapy Llc 250 Cushman St Ste 4f Fairbanks AK 99701-4665 Ph: (907) 987-5088 |
| NPI Number | 1568028140 |
|---|---|
| Provider Enumeration Date | 05/19/2019 |
| Last Update Date | 05/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568028140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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