Provider Demographics
NPI:1407124316
Name:NEW RIVIERA NURSING & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:NEW RIVIERA NURSING & REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:STACEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:NHA/PRESIDENT
Authorized Official - Phone:305-926-0960
Mailing Address - Street 1:6901 YUMURI STREET
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:305-926-0960
Mailing Address - Fax:305-777-7200
Practice Address - Street 1:6901 YUMURI STREET
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:305-926-0960
Practice Address - Fax:305-777-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility