| Organization Name: | RIVERSIDE COUNSELING, TESTING & EDUCATIONAL SERVICES, LLC |
| NPI Number: | 1275545477 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLOTTE A HOLLEMAN (OFFICE MANAGER) |
| Mailing Address: | 519 W Delaware St Purcell |
| State: | OK US |
| Postal Code: | 730805242 |
| Phone Number: | 4055278380 |
| Fax Number: | 4055274549 |
| NPI Enumeration Date: | 08/13/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |