Provider Demographics
NPI:1245221365
Name:RIVERVIEW INVESTMENTS & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:RIVERVIEW INVESTMENTS & ASSOCIATES, LLC
Other - Org Name:RIVERVIEW MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURDETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-308-1845
Mailing Address - Street 1:55378 WILBUR RD
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-8815
Mailing Address - Country:US
Mailing Address - Phone:269-279-7441
Mailing Address - Fax:
Practice Address - Street 1:55378 WILBUR RD
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-8815
Practice Address - Country:US
Practice Address - Phone:269-279-7441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI754030314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI603485175Medicaid
MI235354Medicare ID - Type UnspecifiedMEDICARE NUMBER