Basic Information
| Provider Information | |||||||||
| NPI: | 1134378318 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIVERVIEW HEALTHCARE ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 323 S MINNESOTA ST | ||||||||
| Address2: | |||||||||
| City: | CROOKSTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 567161601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007436551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 SARGENT ST | ||||||||
| Address2: | |||||||||
| City: | CROOKSTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 567161200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182819478 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2008 | ||||||||
| LastUpdateDate: | 09/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | BENNETT | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8007436551 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | 340636 | MN | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.