Basic Information
| Provider Information | |||||||||
| NPI: | 1528062882 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIVERSIDE LANDING NURSING AND REHABILITATION, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7261 ENGLE RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441303479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2167273996 | ||||||||
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| Practice Location | |||||||||
| Address1: | 856 S RIVERSIDE DR NE | ||||||||
| Address2: | |||||||||
| City: | MC CONNELSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437569102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7409625303 | ||||||||
| FaxNumber: | 7409626843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2005 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | PARSONS | ||||||||
| AuthorizedOfficialFirstName: | BENJAMIN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2167273996 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BP3500X | 1595 | OH | N | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | 314000000X | 1595N | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.