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NPI Code Detail

MEDICARE: RIVER CROSSING OPERATOR LLC

MEDICARE: RIVER CROSSING OPERATOR LLC
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1144094608
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER CROSSING OPERATOR LLC
Provider Business Mailing Address
First Line : 311 BLVD OF THE AMERICAS
Second Line : SUITE 201
City : LAKEWOOD
State : NJ
Zip : 08701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11278 SCHUETZ RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4957
Country : US
Telephone Number : 314-991-4066
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JACQUES WOLF
Credential :
Telephone Number : 908-621-1184
Provider Enumeration Date : 11/14/2023
Last Update Date : 11/14/2023

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