Organization
RIVERSIDE NURSING AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORBERT A BENNETT (CEO)
(716) 662-4955
Entity
Organization
Contact information
Practice address
4700 NW CLIFFVIEW DRIVE, RIVERSIDE, MO 64150-1237
(816) 741-5105
(816) 741-5281
Mailing address
PO BOX 428, ORCHARD PARK, NY 14127
(716) 662-4955
(716) 662-2529
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102691607
—
MO
Enumeration date
04/19/2007
Last updated
12/08/2023
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