Riverside Psychiatric Group Sc

LBN: Riverside Psychiatric Group Sc
Riverside Psychiatric Group Sc is an health care organization with primary practice located at 1325 Angels Path Rd , De Pere WI 54115-4050. The organization recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. Riverside Psychiatric Group Sc can be contacted via phone (920) 338-2855, or through Davis, Howard W via phone (920) 338-2800.

Contact Information

Primary practice address
1325 Angels Path Rd De Pere WI 54115-4050
Phone: (920) 338-2855
Fax: (920) 338-9270
Website:
Map and Directions
Authorized official contact:
Name: Davis, Howard W Doctor of Medicine (MD)
Phone: (920) 338-2800

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X Wisconsin
Behavioral Health & Social Service Providers / Psychologist 103T00000X Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X Wisconsin
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X Wisconsin

Profile Details

NPI number 1154520203
LBN Legal business name Riverside Psychiatric Group Sc
DBA Doing business as
Authorized official Davis, Howard W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2007
Last updated Jan 14th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154520203 NPPES
Wisconsin MEDICAID 32884100

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