MEDICARE: RIVERVIEW ADULT DAY CENTER

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1548394877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVIEW ADULT DAY CENTER

Provider Business Mailing Address
First Line	:	2715 E JACKSON BLVD
Second Line	:
City	:	ELKHART
State	:	IN
Zip	:	46516-5053
Country	:	US
Telephone Number	:	574-293-6886
Fax Number	:	574-295-9290

Provider Business Practice Location Address
First Line	:	2715 E JACKSON BLVD
Second Line	:
City	:	ELKHART
State	:	IN
Zip	:	46516-5053
Country	:	US
Telephone Number	:	574-293-6886
Fax Number	:	574-295-9290

Authorized Official
Title or Position	:	BOOKKEEPER
Name	:	WENDY ELLIS
Credential	:
Telephone Number	:	574-293-6886

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	11/07/2022

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