Healthcare Provider Details

I. General information

NPI: 1255667705
Provider Name (Legal Business Name): RIVER FALLS CONVALESCENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 E DIVISION ST
RIVER FALLS WI
54022-1571
US

IV. Provider business mailing address

5174 MCGINNIS FERRY RD SUITE 126
ALPHARETTA GA
30005-1792
US

V. Phone/Fax

Practice location:
  • Phone: 715-426-6000
  • Fax:
Mailing address:
  • Phone: 770-619-0866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateWI

VIII. Authorized Official

Name: EVELYN BROWN
Title or Position: PRESIDENT
Credential:
Phone: 770-619-0866