Provider Demographics
NPI:1376971788
Name:RIVER RIDGE OPERATING LLC
Entity Type:Organization
Organization Name:RIVER RIDGE OPERATING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EINHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-751-4440
Mailing Address - Street 1:1015 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3739
Mailing Address - Country:US
Mailing Address - Phone:917-751-4440
Mailing Address - Fax:
Practice Address - Street 1:100 SANDY DR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-8191
Practice Address - Country:US
Practice Address - Phone:917-751-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility