Organization
RIVIERA MANOR NURSING HOME
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD S. POTEKIN NONE (ADMINISTRATOR)
(708) 481-4444
Entity
Organization
Contact information
Practice address
490 W 16TH PL, CHICAGO HEIGHTS, IL 60411-3224
(708) 481-4444
(708) 481-4606
Mailing address
490 W 16TH PL, CHICAGO HEIGHTS, IL 60411-3224
(708) 481-4444
(708) 481-4606
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0004473
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00004473
—
IL
Enumeration date
06/13/2005
Last updated
08/22/2020
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