Provider Demographics
NPI:1033921168
Name:RIVERSTONE WELLNESS LLC
Entity type:Organization
Organization Name:RIVERSTONE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:228-546-8737
Mailing Address - Street 1:43175 RUGER DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-0871
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43175 RUGER DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-0871
Practice Address - Country:US
Practice Address - Phone:228-546-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch