Provider Demographics
NPI:1235951203
Name:WARREN, RILEY EDEN (BSW)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:EDEN
Last Name:WARREN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SW HIGGINS AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803
Mailing Address - Country:US
Mailing Address - Phone:406-214-3810
Mailing Address - Fax:406-720-7806
Practice Address - Street 1:700 SW HIGGINS AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803
Practice Address - Country:US
Practice Address - Phone:406-214-3810
Practice Address - Fax:406-720-7806
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator