Provider Demographics
NPI:1003851312
Name:RIVER VALLEY CARE CENTER, INC.
Entity Type:Organization
Organization Name:RIVER VALLEY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-961-1212
Mailing Address - Street 1:140 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3018
Mailing Address - Country:US
Mailing Address - Phone:845-454-7600
Mailing Address - Fax:718-461-9484
Practice Address - Street 1:140 MAIN ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3018
Practice Address - Country:US
Practice Address - Phone:845-454-7600
Practice Address - Fax:718-461-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1302307N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02194985Medicaid
NY02993497Medicaid
NY02993497Medicaid