Basic Information
| Provider Information | |||||||||
| NPI: | 1023693181 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIPLEY SNF OPERATIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1007 BROADWAY FL 2 | ||||||||
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| City: | WOODMERE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115981246 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 107 MILLER DR | ||||||||
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| City: | RIPLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 252711133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043725115 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2021 | ||||||||
| LastUpdateDate: | 03/10/2021 | ||||||||
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| AuthorizedOfficialLastName: | LIEBERMAN | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCIAL OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 6462754510 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.