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General NPI Number Information
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NPI Number | 1134378318
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Entity Type | Organization
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Legal Business Name | RIVERVIEW HEALTHCARE ASSOCIATION
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 110 SARGENT ST
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City | CROOKSTON
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State | MN
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Zip | 56716-1200
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Country | US
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Telephone | 218-281-9478
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Fax |
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Provider Business Mailing Address
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Address Line | 323 S MINNESOTA ST
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City | CROOKSTON
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State | MN
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Zip | 56716-1601
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Country | US
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Telephone | 800-743-6551
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | WILLIAM BENNETT
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Credential |
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Telephone | 800-743-6551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 340636
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License Number State | MN
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