RIVERS EDGE BEHAVIORAL HEALTH LLC (NPI# 1700365087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700365087 |
| Entity Type | Organization |
| Organization Name | RIVERS EDGE BEHAVIORAL HEALTH LLC |
| Practice Address |
2690 N 17th St Coos Bay OR 97420 |
| Mailing Address |
2690 N 17th St Coos Bay OR 97420-2134 |
| Practice Telephone | 5412695333 |
| Practice Fax Number | 5412695609 |
| Mailing Telephone | 5412695333 |
| Mailing Fax Number | 5412695609 |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2020-04-17 |
| Authorized Official Name | DR. ROBERT WILLIAM GERBER (OWNER) |
| Authorized Official Telephone | 5412695333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500754219 | 05 | |
| OR | 500754223 | 05 |
| Street Address |
2690 N 17TH ST |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518941350 | Robert William Gerber | Family Medicine | 2690 N 17th St, Coos Bay, OR 97420 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265039564 | Embodied Life Therapy Center LLC | Clinic/Center | 6906 N Richards St, Portland, OR 97203-6138 | 2020-10-08 |
| 1720685696 | Pragmatic Healing LLC | Clinic/Center | 3930 Sw Plum St Apt 1, Portland, OR 97219-6046 | 2020-10-05 |
| 1639793367 | Northwest Geriactrics | Clinic/Center | 10365 Se Sunnyside Rd Ste 340, Clackamas, OR 97015-5751 | 2020-05-28 |
| 1366065872 | Caring Hands Residential Services LLC | Clinic/Center | 16220 Se Mckinley Ave, Clackamas, OR 97015-9418 | 2020-05-19 |
| 1972139947 | Kevin Ryan PC | Clinic/Center | 119 E 2nd St Ste 210, The Dalles, OR 97058-1796 | 2020-03-21 |
| 1083240386 | Peace of Mind Functional Medicine | Clinic/Center | 151 Sw Shevlin Hixon Dr Ste 201, Bend, OR 97702-3233 | 2020-03-18 |
| 1467086215 | Deborah Ann Jewell | Clinic/Center | 5627 Ne Simpson St, Portland, OR 97218-2329 | 2020-03-01 |
| 1154802403 | Dr. Asha Stephen, LLC | Clinic/Center | 1234 Pearl St Ste 7, Eugene, OR 97401-3642 | 2018-08-24 |
| 1891272324 | Cressall Psychiatric LLC | Clinic/Center | 240 E 12th Ave, Eugene, OR 97401-3245 | 2018-07-26 |
| 1174023808 | Blake Locher Counseling, LLC | Clinic/Center | 1020 Sw Taylor St Ste 449, Portland, OR 97205-2556 | 2018-02-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.