Provider Demographics
NPI:1811038250
Name:RIVERVIEW MANOR INC.
Entity Type:Organization
Organization Name:RIVERVIEW MANOR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:MCKAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-455-2214
Mailing Address - Street 1:200 S OHIO
Mailing Address - Street 2:BOX 458
Mailing Address - City:OXFORD
Mailing Address - State:KS
Mailing Address - Zip Code:67119-8080
Mailing Address - Country:US
Mailing Address - Phone:620-455-2214
Mailing Address - Fax:620-455-2497
Practice Address - Street 1:200 S OHIO
Practice Address - Street 2:BOX 458
Practice Address - City:OXFORD
Practice Address - State:KS
Practice Address - Zip Code:67119-8080
Practice Address - Country:US
Practice Address - Phone:620-455-2214
Practice Address - Fax:620-455-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSNO96005314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175450Medicare Oscar/Certification