Organization
RIVERSIDE NURSING - CENTRALIA LLC
Active
Other names
Riverside Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOV E JACOBS (MANAGER)
(323) 678-4426
Entity
Organization
Contact information
Practice address
1305 ALEXANDER ST, CENTRALIA, WA 98531-1305
(360) 736-2823
(360) 736-1821
Mailing address
1305 ALEXANDER ST, CENTRALIA, WA 98531-1305
(360) 736-2823
(360) 736-1821
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4197000
—
WA
Enumeration date
11/17/2006
Last updated
07/21/2022
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