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General NPI Number Information
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NPI Number | 1578356036
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Entity Type | Organization
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Legal Business Name | RIVERSIDE HOME CARE LLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | N7559 PINE RIDGE CIR
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City | PORTAGE
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State | WI
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Zip | 53901-8815
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Country | US
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Telephone | 608-697-5377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 742
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City | PORTAGE
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State | WI
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Zip | 53901-0742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEFANIE YAHNKE
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Credential |
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Telephone | 608-617-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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