Provider Demographics
NPI:1962472316
Name:RIVERSIDE TRANSITIONAL CARE
Entity Type:Organization
Organization Name:RIVERSIDE TRANSITIONAL CARE
Other - Org Name:RIVERSIDE TRANSITIONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PATIENT FINANCIAL SVCS.
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-623-7165
Mailing Address - Street 1:700 W. LEA BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2500
Mailing Address - Country:US
Mailing Address - Phone:302-765-4400
Mailing Address - Fax:
Practice Address - Street 1:700 W. LEA BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2500
Practice Address - Country:US
Practice Address - Phone:302-765-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIANA CARE HEALTH SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-26
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
314000000X
DE1224314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE085038Medicare Oscar/Certification