Provider Demographics
NPI:1457687808
Name:RIVER OAKS SNF LLC
Entity Type:Organization
Organization Name:RIVER OAKS SNF LLC
Other - Org Name:RIVER OAKS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ZEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-370-9063
Mailing Address - Street 1:2225 E RANDOL MILL RD
Mailing Address - Street 2:STE 630
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6315
Mailing Address - Country:US
Mailing Address - Phone:817-607-7400
Mailing Address - Fax:
Practice Address - Street 1:100 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-6927
Practice Address - Country:US
Practice Address - Phone:940-766-0279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675029Medicare Oscar/Certification