MEDICARE: RIVERVIEW ADULT DAYCARE CENTER, 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	261QA0600X	Adult Day Care Clinic/Center	663	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174654297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVIEW ADULT DAYCARE CENTER, INC.

Provider Business Mailing Address
First Line	:	8941 RIVERVIEW DR
Second Line	:	RIVERVIEW PLAZA
City	:	SAINT LOUIS
State	:	MO
Zip	:	63137-2404
Country	:	US
Telephone Number	:	314-868-3030
Fax Number	:	314-868-3043

Provider Business Practice Location Address
First Line	:	8941 RIVERVIEW DR
Second Line	:	RIVERVIEW PLAZA
City	:	SAINT LOUIS
State	:	MO
Zip	:	63137-2404
Country	:	US
Telephone Number	:	314-868-3030
Fax Number	:	314-868-3043

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MARTHA NASH
Credential	:
Telephone Number	:	314-868-3030

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	12/08/2008

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