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Organization

RIVERSIDE LODGEM INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBRA FRIEND (EXECUTIVE DIRECTOR)
(308) 382-1657
Entity
Organization

Contact information

Practice address
404 WOODLAND DR, GRAND ISLAND, NE 68801-8906
(308) 382-1657
(308) 381-1863
Mailing address
404 WOODLAND DR, GRAND ISLAND, NE 68801-8906
(308) 382-1657
(308) 381-0433

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALF148
NE

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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