Provider Demographics
NPI:1538320940
Name:RIVERSTONE SENIOR LIFE SERVICES
Entity Type:Organization
Organization Name:RIVERSTONE SENIOR LIFE SERVICES
Other - Org Name:FORT WASHINGTON HOUSES SERVICES FOR THE ELDERLY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ILANA
Authorized Official - Middle Name:DORIT
Authorized Official - Last Name:DUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-927-5600
Mailing Address - Street 1:99 FORT WASHINGTON AVE.
Mailing Address - Street 2:
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-927-5600
Mailing Address - Fax:212-927-5612
Practice Address - Street 1:99 FORT WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-927-5600
Practice Address - Fax:212-927-5612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable