Provider Demographics
NPI:1255328159
Name:THE RIVERWOODS COMPANY AT EXETER, NEW HAMPSHIRE
Entity Type:Organization
Organization Name:THE RIVERWOODS COMPANY AT EXETER, NEW HAMPSHIRE
Other - Org Name:RIVERWOODS AT EXETER
Other - Org Type:Other Name
Authorized Official - Title/Position:ACCOUNTING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-658-1580
Mailing Address - Street 1:7 RIVERWOODS DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4374
Mailing Address - Country:US
Mailing Address - Phone:603-742-4700
Mailing Address - Fax:
Practice Address - Street 1:7 RIVERWOODS DR
Practice Address - Street 2:RIVERWOODS AT EXETER
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4374
Practice Address - Country:US
Practice Address - Phone:603-742-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02112314000000X
NH140784363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH305049Medicare ID - Type UnspecifiedPROVIDER NUMBER