Healthcare Provider Details

I. General information

NPI: 1528062882
Provider Name (Legal Business Name): RIVERSIDE LANDING NURSING AND REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 S RIVERSIDE DR
MC CONNELSVILLE OH
43756-9102
US

IV. Provider business mailing address

2875 CENTER RD STE 6
BRUNSWICK OH
44212-2319
US

V. Phone/Fax

Practice location:
  • Phone: 740-962-5303
  • Fax: 740-962-6843
Mailing address:
  • Phone: 216-772-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number1595
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1595N
License Number StateOH

VIII. Authorized Official

Name: BENJAMIN J PARSONS
Title or Position: PRESIDENT
Credential:
Phone: 216-727-3996