Provider Demographics
NPI:1093723389
Name:RIVER'S BEND HEALTH CARE, LLC
Entity Type:Organization
Organization Name:RIVER'S BEND HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:740-894-3476
Mailing Address - Street 1:335 TOWNSHIP ROAD 1026
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-7842
Mailing Address - Country:US
Mailing Address - Phone:740-894-3476
Mailing Address - Fax:740-894-3086
Practice Address - Street 1:335 TOWNSHIP ROAD 1026
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-7842
Practice Address - Country:US
Practice Address - Phone:740-894-3476
Practice Address - Fax:740-894-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6391314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2385619Medicaid
OH366265Medicare Oscar/Certification