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NPI Code Detail

MEDICARE: RIVER RIDGE LIVING CENTER, LLC

MEDICARE: RIVER RIDGE LIVING CENTER, 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 Facility0460026NY

Other Identifiers

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

General Provider Information

NPI Number : 1285632877
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER RIDGE LIVING CENTER, LLC
Provider Business Mailing Address
First Line : 100 SANDY DR
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-8191
Country : US
Telephone Number : 518-843-3503
Fax Number : 518-843-3537
Provider Business Practice Location Address
First Line : 100 SANDY DR
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-8191
Country : US
Telephone Number : 518-843-3503
Fax Number : 518-843-3537
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MS. HEATHER E REYNICKE
Credential :
Telephone Number : 518-843-3503
Provider Enumeration Date : 07/08/2005
Last Update Date : 08/22/2020

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Directions to “RIVER RIDGE LIVING CENTER, LLC ” Practice Location

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