Organization
CCLA 9 LLC
Active
Other names
Riverview Health & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM KAMEGO (DIRECTOR OF OPERATIONS)
(586) 563-1500
Entity
Organization
Contact information
Practice address
7733 E JEFFERSON AVE, DETROIT, MI 48214-3707
(313) 499-4100
(313) 499-4934
Mailing address
PO BOX 250459, FRANKLIN, MI 48025-0459
(586) 563-1500
(568) 563-1200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851691844
NPI
—
05
—
60-1950507
—
MI
Enumeration date
09/21/2011
Last updated
09/21/2011
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