Provider Demographics
NPI:1730115189
Name:THAMES HEALTHCARE GROUP, LLC
Entity Type:Organization
Organization Name:THAMES HEALTHCARE GROUP, LLC
Other - Org Name:RIVERS EDGE NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-523-9094
Mailing Address - Street 1:6301 BASS RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9384
Mailing Address - Country:US
Mailing Address - Phone:502-228-8359
Mailing Address - Fax:502-228-5469
Practice Address - Street 1:6301 BASS RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9384
Practice Address - Country:US
Practice Address - Phone:502-228-8359
Practice Address - Fax:502-228-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100430314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2705895000OtherPASSPORT ADVANTAGE
KY7100168760Medicaid
KY000000054459OtherBCBS OF KY
KY12501250Medicaid
KY7100168760Medicaid