Provider Demographics
NPI:1003899352
Name:UNITED CHURCH HOMES, INC
Entity Type:Organization
Organization Name:UNITED CHURCH HOMES, INC
Other - Org Name:RIVERVIEW COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT IT SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISBRODT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-382-4885
Mailing Address - Street 1:5999 BENDER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-1601
Mailing Address - Country:US
Mailing Address - Phone:513-922-1440
Mailing Address - Fax:513-922-2927
Practice Address - Street 1:5999 BENDER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-1601
Practice Address - Country:US
Practice Address - Phone:513-922-1440
Practice Address - Fax:513-922-2927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4511314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0055416Medicaid
OH365530Medicare ID - Type Unspecified