MEDICARE: RIVER HILL ASSISTED LIVING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	337592	MN

General Provider Information

NPI Number	:	1093999773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER HILL ASSISTED LIVING, INC.

Provider Business Mailing Address
First Line	:	126-98TH AVENUE WEST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 98 AVE WEST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55808-2110
Country	:	US
Telephone Number	:	218-626-3322
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	PATRICE STENHAMMER
Credential	:
Telephone Number	:	218-626-3322

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	12/18/2007

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