Organization
RIVERSIDE NURSING HOME LLC
Active
Other names
RIVERSIDE NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY W DELATTE (CFO)
(225) 664-6697
Entity
Organization
Contact information
Practice address
3001 S GRAND ST, MONROE, LA 71202-4152
(318) 388-3200
(318) 388-2909
Mailing address
3001 S GRAND ST, MONROE, LA 71202-4152
(318) 388-3200
(318) 388-2909
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
58
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517810
—
LA
Enumeration date
09/11/2008
Last updated
11/10/2009
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