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General NPI Number Information
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NPI Number | 1285632877
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Entity Type | Organization
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Legal Business Name | RIVER RIDGE LIVING CENTER, LLC
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 SANDY DR
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City | AMSTERDAM
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State | NY
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Zip | 12010-8191
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Country | US
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Telephone | 518-843-3503
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Fax | 518-843-3537
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Provider Business Mailing Address
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Address Line | 100 SANDY DR
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City | AMSTERDAM
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State | NY
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Zip | 12010-8191
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Country | US
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Telephone | 518-843-3503
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Fax | 518-843-3537
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. HEATHER E REYNICKE
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Credential |
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Telephone | 518-843-3503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0460026
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License Number State | NY
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