# RIVERSIDE CONGREGATIONAL HOMES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PLYMOUTH TOWER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134124415
- **Authorized official:** STUART HARTMAN (V.P. OF OPERATIONS)
- **Authorized official phone:** (562) 257-5100

## Contact information

- **Practice address:** 3401 LEMON ST, RIVERSIDE, CA 92501-2817
- **Practice address phone:** (951) 686-8202
- **Practice address fax:** (951) 784-1508
- **Mailing address:** 3401 LEMON ST, RIVERSIDE, CA 92501-2817
- **Mailing address phone:** (951) 686-8202
- **Mailing address fax:** (951) 784-1508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | CA | Yes |

## Other

- **Enumeration date:** 06/14/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT18656F | — | CA |