Provider Demographics
NPI:1528021698
Name:RIVERVIEW CARE CENTER, LLC
Entity Type:Organization
Organization Name:RIVERVIEW CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-357-6055
Mailing Address - Street 1:4 IVYBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1700
Mailing Address - Country:US
Mailing Address - Phone:215-357-6055
Mailing Address - Fax:215-357-6968
Practice Address - Street 1:1 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-7016
Practice Address - Country:US
Practice Address - Phone:215-357-6055
Practice Address - Fax:215-357-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03-051314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
68720701OtherBLUE CROSS
=========OtherELDERHEALTH
68720701OtherBLUE CROSS