Provider Demographics
NPI:1437696200
Name:RIVER TO RIVER RESIDENTIAL CORP
Entity Type:Organization
Organization Name:RIVER TO RIVER RESIDENTIAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTER-HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-993-7533
Mailing Address - Street 1:P.O. BOX 1759
Mailing Address - Street 2:1500 SANDBAR DRIVE
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959
Mailing Address - Country:US
Mailing Address - Phone:618-993-7533
Mailing Address - Fax:618-993-7531
Practice Address - Street 1:1500 SANDBAR DRIVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959
Practice Address - Country:US
Practice Address - Phone:618-993-7533
Practice Address - Fax:618-993-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherEIN