Provider Demographics
NPI:1710168844
Name:RIVERCOURT LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:RIVERCOURT LIMITED PARTNERSHIP
Other - Org Name:RIVERCOURT RESIDENCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERDMAN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MBA, MPH
Authorized Official - Phone:978-448-4122
Mailing Address - Street 1:8 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1631
Mailing Address - Country:US
Mailing Address - Phone:978-448-4122
Mailing Address - Fax:978-448-4133
Practice Address - Street 1:8 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1631
Practice Address - Country:US
Practice Address - Phone:978-448-4122
Practice Address - Fax:978-448-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility