Healthcare Provider Details

I. General information

NPI: 1457206856
Provider Name (Legal Business Name): RIVERSIDE COMMONS REHAB AND NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16391 ROTUNDA DR
DEARBORN MI
48120-1172
US

IV. Provider business mailing address

1200 RIVER AVE STE 7B-18
LAKEWOOD NJ
08701-5657
US

V. Phone/Fax

Practice location:
  • Phone: 313-253-9700
  • Fax:
Mailing address:
  • Phone: 718-807-1941
  • 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: MOSHE GOTTLIEB
Title or Position: MEMBER
Credential:
Phone: 718-807-1941