Provider Demographics
NPI:1336291491
Name:RIVERSIDE ALF, INC
Entity Type:Organization
Organization Name:RIVERSIDE ALF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-788-8350
Mailing Address - Street 1:420 N RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-5035
Mailing Address - Country:US
Mailing Address - Phone:954-788-8350
Mailing Address - Fax:954-788-8350
Practice Address - Street 1:420 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-5035
Practice Address - Country:US
Practice Address - Phone:954-788-8350
Practice Address - Fax:954-788-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10156310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility