Healthcare Provider Details

I. General information

NPI: 1811918436
Provider Name (Legal Business Name): RIVERVIEW HEALTHCARE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 CENTRAL AVE NE
EAST GRAND FORKS MN
56721-1605
US

IV. Provider business mailing address

323 S MINNESOTA ST
CROOKSTON MN
56716-1601
US

V. Phone/Fax

Practice location:
  • Phone: 218-773-1390
  • Fax: 218-773-1762
Mailing address:
  • Phone: 218-281-9200
  • Fax: 218-281-9224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BETTY J ARVIDSON
Title or Position: CFO
Credential:
Phone: 218-281-9756