Provider Demographics
NPI:1508362120
Name:LANDMARK OF RIVER CITY REHABILITATION AND NURSING CENTER
Entity Type:Organization
Organization Name:LANDMARK OF RIVER CITY REHABILITATION AND NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-281-4200
Mailing Address - Street 1:6101 NIMTZ PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-6111
Mailing Address - Country:US
Mailing Address - Phone:269-281-4200
Mailing Address - Fax:
Practice Address - Street 1:1015 MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2017
Practice Address - Country:US
Practice Address - Phone:502-254-4201
Practice Address - Fax:502-254-4209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility