Provider Demographics
NPI:1740090620
Name:RIVER CITY REHAB LLC
Entity type:Organization
Organization Name:RIVER CITY REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINKING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-797-6824
Mailing Address - Street 1:3119 LOSEY BLVD S
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-7336
Mailing Address - Country:US
Mailing Address - Phone:608-797-6824
Mailing Address - Fax:
Practice Address - Street 1:3119 LOSEY BLVD S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-7336
Practice Address - Country:US
Practice Address - Phone:608-797-6824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty