Provider Demographics
NPI:1942201181
Name:RIVERCREST HEALTH SERVICES
Entity Type:Organization
Organization Name:RIVERCREST HEALTH SERVICES
Other - Org Name:ANCHORAGE NURSING AND REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-625-1502
Mailing Address - Street 1:105 TIME SQ
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2808
Mailing Address - Country:US
Mailing Address - Phone:410-749-2474
Mailing Address - Fax:410-749-5194
Practice Address - Street 1:105 TIME SQ
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2808
Practice Address - Country:US
Practice Address - Phone:410-749-2474
Practice Address - Fax:410-749-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22008314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD215339Medicare ID - Type UnspecifiedMEDI CARE