Provider Demographics
NPI:1871020248
Name:PLATINUM HEALTH AT RIVERSIDE LLC
Entity Type:Organization
Organization Name:PLATINUM HEALTH AT RIVERSIDE LLC
Other - Org Name:RIVERSIDE REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-474-7967
Mailing Address - Street 1:500 W HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-2012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 W HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:PA
Practice Address - Zip Code:18517-2012
Practice Address - Country:US
Practice Address - Phone:570-562-2102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility