Healthcare Provider Details

I. General information

NPI: 1609874585
Provider Name (Legal Business Name): RIVINGTON HOUSE HEALTH CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 RIVINGTON ST
NEW YORK NY
10002-1304
US

IV. Provider business mailing address

154 CHRISTOPHER ST SUITE 2D
NEW YORK NY
10014-2840
US

V. Phone/Fax

Practice location:
  • Phone: 212-539-6200
  • Fax: 212-477-3121
Mailing address:
  • Phone: 212-337-5600
  • Fax: 212-924-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7002353N
License Number StateNY

VIII. Authorized Official

Name: MRS. EMMA DEVITO
Title or Position: PRESIDENT/CEO
Credential:
Phone: 212-337-5760