Provider Demographics
NPI:1235236225
Name:RIVERBEND NURSING AND REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:RIVERBEND NURSING AND REHABILITATION CENTER INC
Other - Org Name:RIVERBEND NURSING AND REHABILITATION CE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-626-1900
Mailing Address - Street 1:13735 HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-4151
Mailing Address - Country:US
Mailing Address - Phone:504-656-0068
Mailing Address - Fax:504-656-0037
Practice Address - Street 1:13735 HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-4151
Practice Address - Country:US
Practice Address - Phone:504-656-0068
Practice Address - Fax:504-656-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA739314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1521116Medicaid
LA195481Medicare Oscar/Certification