Provider Demographics
NPI:1639176639
Name:RIVERVIEW ACQUISITION COMPANY, LLC
Entity Type:Organization
Organization Name:RIVERVIEW ACQUISITION COMPANY, LLC
Other - Org Name:REGENCY AT BLUFFS PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ASHRAF
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-386-0300
Mailing Address - Street 1:355 HURONVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2949
Mailing Address - Country:US
Mailing Address - Phone:734-761-3800
Mailing Address - Fax:734-761-3802
Practice Address - Street 1:355 HURONVIEW BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2949
Practice Address - Country:US
Practice Address - Phone:734-761-3800
Practice Address - Fax:734-761-3802
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIENA HEALTHCARE MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-05
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIS9682OtherBCBS
MIS9682OtherBCBS