Provider Demographics
NPI:1295961969
Name:RIVER OAKS MANAGEMENT, LLC
Entity type:Organization
Organization Name:RIVER OAKS MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PPM
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVERTICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-376-2951
Mailing Address - Street 1:150 PLANTATION BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-7128
Mailing Address - Country:US
Mailing Address - Phone:601-953-4891
Mailing Address - Fax:
Practice Address - Street 1:501 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-3257
Practice Address - Country:US
Practice Address - Phone:601-825-1757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH MANAGEMENT ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-08
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR851997313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility