# RIVERSIDE CONVALESCENT CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Rehabilitation Center at Hampton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215043732
- **Authorized official:** MR. WALTER W AUSTIN (SENIOR VP, LTC)
- **Authorized official phone:** (757) 875-7846

## Contact information

- **Practice address:** 414 ALGONQUIN RD, HAMPTON, VA 23661-1605
- **Practice address phone:** (757) 722-9881
- **Practice address fax:** (757) 723-3605
- **Mailing address:** 608 DENBIGH BLVD, SUITE 600, NEWPORT NEWS, VA 23608-4410
- **Mailing address phone:** (757) 875-2023
- **Mailing address fax:** (757) 875-2016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH2666 | VA | Yes |
| 314000000X | Skilled Nursing Facility | NH2666 | VA | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | NH2666 | VA | — |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 01/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004953088 | — | VA |