Provider Demographics
NPI:1699217117
Name:RIVERSIDE KEEPERS
Entity Type:Organization
Organization Name:RIVERSIDE KEEPERS
Other - Org Name:ANGELS FOR ELDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GUILFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-847-7080
Mailing Address - Street 1:201 FM 3237
Mailing Address - Street 2:SUITE 124
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-2117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 FM 3237
Practice Address - Street 2:SUITE 124
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-2117
Practice Address - Country:US
Practice Address - Phone:512-847-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7970253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care