Basic Information
| Provider Information | |||||||||
| NPI: | 1619072048 | ||||||||
| 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: | 2182819200 | ||||||||
| FaxNumber: | 2182819224 | ||||||||
| Practice Location | |||||||||
| Address1: | 323 S MINNESOTA ST | ||||||||
| Address2: | |||||||||
| City: | CROOKSTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 567161601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007436551 | ||||||||
| FaxNumber: | 2182819224 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 01/22/2019 | ||||||||
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| AuthorizedOfficialLastName: | ARVIDSON | ||||||||
| AuthorizedOfficialFirstName: | BETTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2182819756 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | Y | Hospital Units | Medicare Defined Swing Bed Unit |
No ID Information.