# RIVERSIDE ASSISTED LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Place Assisted Living Community
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952320111
- **Authorized official:** CHRISTOPHER BROGDON (MANAGER)
- **Authorized official phone:** (770) 650-7086

## Contact information

- **Practice address:** 1151 W COLLEGE ST, BAINBRIDGE, GA 39819-6400
- **Practice address phone:** (229) 248-1116
- **Practice address fax:** (229) 248-4115
- **Mailing address:** 1151 W COLLEGE ST, BAINBRIDGE, GA 39819-6400
- **Mailing address phone:** (229) 248-1116
- **Mailing address fax:** (229) 248-4115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | GA | Yes |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 08/22/2020