Provider Demographics
NPI:1669107454
Name:RVR CORPORATION
Entity type:Organization
Organization Name:RVR CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:V
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-832-8792
Mailing Address - Street 1:17544 SAN JOSE ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6009
Mailing Address - Country:US
Mailing Address - Phone:805-832-8792
Mailing Address - Fax:818-217-4660
Practice Address - Street 1:17544 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6009
Practice Address - Country:US
Practice Address - Phone:805-217-4660
Practice Address - Fax:818-217-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197609853OtherRCFE LICENSE