Healthcare Provider Details

I. General information

NPI: 1629274550
Provider Name (Legal Business Name): RIVERVIEW HEALTH & REHABILITATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6711 LAROCHE AVE
SAVANNAH GA
31406
US

IV. Provider business mailing address

6711 LAROCHE AVE
SAVANNAH GA
31406
US

V. Phone/Fax

Practice location:
  • Phone: 912-354-8225
  • Fax: 912-790-3238
Mailing address:
  • Phone: 912-354-8225
  • Fax: 912-790-3238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY O. BURROUGHS
Title or Position: NHA #646
Credential: ADMINISTRATOR
Phone: 912-398-3254