Healthcare Provider Details

I. General information

NPI: 1265496244
Provider Name (Legal Business Name): RIVERSIDE HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 HUMBOLDT RD SUITE #175
CHICO CA
95928-9116
US

IV. Provider business mailing address

1469 HUMBOLDT RD SUITE #175
CHICO CA
95928-9116
US

V. Phone/Fax

Practice location:
  • Phone: 530-897-5100
  • Fax: 530-897-5105
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TERRY E BANE
Title or Position: PRESIDENT
Credential:
Phone: 530-897-5100