Provider Demographics
NPI:1568359651
Name:RIVER ROCK YOGA LLC
Entity type:Organization
Organization Name:RIVER ROCK YOGA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:228-365-3191
Mailing Address - Street 1:3670 GROVELAND RD STE A
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5754
Mailing Address - Country:US
Mailing Address - Phone:228-365-3191
Mailing Address - Fax:228-875-9065
Practice Address - Street 1:3670 GROVELAND RD STE A
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5754
Practice Address - Country:US
Practice Address - Phone:228-365-3191
Practice Address - Fax:228-875-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty