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1356308399

NPI Code Detail

MEDICARE: RIVERSIDE HEALTH CARE CENTER

MEDICARE: RIVERSIDE HEALTH CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QH0700X	Hearing and Speech Clinic/Center
3	261QP2000X	Physical Therapy Clinic/Center
4	261QR0400X	Rehabilitation Clinic/Center
5	314000000X	Skilled Nursing Facility	9926	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	4076-2	OTHER		BCBS OF MONTANA

General Provider Information

NPI Number	:	1356308399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSIDE HEALTH CARE CENTER

Provider Business Mailing Address
First Line	:	1107 HAZELTINE BLVD
Second Line	:	SUITE 200
City	:	CHASKA
State	:	MN
Zip	:	55318-1009
Country	:	US
Telephone Number	:	952-361-8000
Fax Number	:	952-361-8058

Provider Business Practice Location Address
First Line	:	1301 E BROADWAY ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4905
Country	:	US
Telephone Number	:	406-721-0680
Fax Number	:	406-721-9788

Authorized Official
Title or Position	:	CHAIRMAN OF THE BOARD
Name	:	JAMES A WEICHERT
Credential	:
Telephone Number	:	952-361-8000

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	09/24/2024

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Directions to “RIVERSIDE HEALTH CARE CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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