Provider Demographics
NPI:1740212265
Name:RDG HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:RDG HEALTHCARE CORPORATION
Other - Org Name:DANIELS HOUSE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARCIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-556-5900
Mailing Address - Street 1:25 RAILROAD SQ
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-5721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:59 MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2533
Practice Address - Country:US
Practice Address - Phone:781-944-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0308313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0917494Medicaid