Provider Demographics
NPI:1275702375
Name:RIVERTON TRANSITIONAL REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:RIVERTON TRANSITIONAL REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-446-8400
Mailing Address - Street 1:3419 WEST 12600 SOUTH
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-6515
Mailing Address - Country:US
Mailing Address - Phone:801-446-8400
Mailing Address - Fax:801-316-9476
Practice Address - Street 1:3419 WEST 12600 SOUTH
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-6515
Practice Address - Country:US
Practice Address - Phone:801-446-8400
Practice Address - Fax:801-316-9476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility