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General NPI Number Information
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NPI Number | 1679559520
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Entity Type | Organization
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Legal Business Name | RIVERVIEW ACQUISITION COMPANY , LLC
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 510 5TH AVE
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City | OWEGO
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State | NY
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Zip | 13827-1620
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Country | US
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Telephone | 607-687-2594
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Fax | 607-687-9580
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Provider Business Mailing Address
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Address Line | 510 5TH AVE
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City | OWEGO
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State | NY
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Zip | 13827-1620
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Country | US
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Telephone | 607-687-2594
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Fax | 607-687-9580
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Authorized Official
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Title or Position | MANAGER, FISCAL OVERSIGHT
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Name | MR. JONATHAN GEWIRTZ
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Credential |
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Telephone | 914-588-8379
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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 | 5324302N
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License Number State | NY
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