Provider Demographics
NPI:1518969203
Name:RIVERVIEW HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:RIVERVIEW HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-997-2481
Mailing Address - Street 1:611 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:FLANDREAU
Mailing Address - State:SD
Mailing Address - Zip Code:57028-1301
Mailing Address - Country:US
Mailing Address - Phone:605-997-2481
Mailing Address - Fax:605-997-2988
Practice Address - Street 1:611 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:FLANDREAU
Practice Address - State:SD
Practice Address - Zip Code:57028-1301
Practice Address - Country:US
Practice Address - Phone:605-997-2481
Practice Address - Fax:605-997-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10620314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD10620Medicaid
SD435086Medicare ID - Type Unspecified
SD437059Medicare ID - Type UnspecifiedHOME HEALTH AGENCY