| NPI | 1992073084 | 
|---|---|
| Doing Business As | RIVERSIDE MENTAL AND MEDICAL CLINIC | 
| Entity Type | Organization | 
| Authorized Contact | BENJAMIN ADEWALE CEO 703-569-8028  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC MD22004)  | 
| Enumeration Date | 2011-12-05 | 
| Last Update Date | 2013-07-30 |