Provider Demographics
NPI:1407386030
Name:SIMMS ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:SIMMS ASSISTED LIVING LLC
Other - Org Name:RIVER OAK ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MSN
Authorized Official - Phone:252-524-4028
Mailing Address - Street 1:716 WALL ST
Mailing Address - Street 2:
Mailing Address - City:GRIFTON
Mailing Address - State:NC
Mailing Address - Zip Code:28530-7035
Mailing Address - Country:US
Mailing Address - Phone:252-524-4028
Mailing Address - Fax:252-524-3739
Practice Address - Street 1:716 WALL ST
Practice Address - Street 2:
Practice Address - City:GRIFTON
Practice Address - State:NC
Practice Address - Zip Code:28530-7035
Practice Address - Country:US
Practice Address - Phone:252-524-4028
Practice Address - Fax:252-524-3739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL074043310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility