Healthcare Provider Details

I. General information

NPI: 1093723389
Provider Name (Legal Business Name): RIVER'S BEND HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 TOWNSHIP ROAD 1026
SOUTH POINT OH
45680-7842
US

IV. Provider business mailing address

335 TOWNSHIP ROAD 1026
SOUTH POINT OH
45680-7842
US

V. Phone/Fax

Practice location:
  • Phone: 740-894-3476
  • Fax: 740-894-3086
Mailing address:
  • Phone: 740-894-3476
  • Fax: 740-894-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number6391
License Number StateOH

VIII. Authorized Official

Name: MR. RONALD G LYONS
Title or Position: NURSING HOME ADMINISTRATOR
Credential: NHA
Phone: 740-894-3476