Organization Name: | RIVERSIDE PSYCHIATRIC GROUP SC |
NPI Number: | 1154520203 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HOWARD W DAVIS (PRESIDENT) |
Mailing Address: | 1325 Angels Path Rd De Pere |
State: | WI US |
Postal Code: | 541154050 |
Phone Number: | 9203382855 |
Fax Number: | 9203389270 |
NPI Enumeration Date: | 07/17/2007 |
NPI Last Update Date: | 01/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |