Healthcare Provider Details

I. General information

NPI: 1497409858
Provider Name (Legal Business Name): RICHFIELD NURSING AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 02/04/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 MAIN ST
RICHFIELD PA
17086-8691
US

IV. Provider business mailing address

34 LORD AVE
LAWRENCE NY
11559-1324
US

V. Phone/Fax

Practice location:
  • Phone: 717-694-3434
  • Fax:
Mailing address:
  • Phone:
  • 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: AKIKO IKE
Title or Position: MANAGING MEMBER
Credential:
Phone: 646-580-8388