Riverside Community Services

NPI #1164207239 in Lisbon, Maine

Provider Information

NPI Number: 1164207239
Entity Type: Organization
Organization Name: Riverside Community Services
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 28, 2023
Last Updated: Aug 28, 2023

Practice Location

Address: 15 CHERYL DEE AVE
City: Lisbon
State: Maine
ZIP Code: 04250-6056
Phone: (207) 409-2638

Authorized Official

Name: RAPHAEL KABATA NGAYKALA
Title: CEO
Phone: (207) 409-2638

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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