Organization
RIVERSIDE SCC LLC
Active
Other names
Riverside Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
(214) 252-7600
Entity
Organization
Contact information
Practice address
6801 E RIVERSIDE DR, AUSTIN, TX 78741-6633
(512) 247-9000
(512) 697-2701
Mailing address
600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
(214) 252-7600
(214) 252-7704
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026806
—
TX
01
—
5575 104266
VENDOR ID/FACILITY ID
TX
Enumeration date
12/18/2014
Last updated
03/04/2020
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