Diversicare Of Riverside, LLC
Skilled Nursing Facility in Saint Joseph, MO. Organization (NPI-2).
NPI number1669887352
StatusActive
Last updated in NPPESApr 7, 2023
Details
- NPI
- 1669887352
- Entity type
- Organization (NPI-2)
- Legal business name
- Diversicare Of Riverside, LLC
- Organization subpart
- Yes
- Enumeration date
- Jun 22, 2014
- Certification date
- Apr 7, 2023
- Last updated
- Apr 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 042401 | MO | Yes |
| 310400000X | Assisted Living Facility | 042402 | MO |
Other names
- Riverside Place (Doing Business As)
Practice location
1616 Weisenborn RdSaint Joseph, MO 64507-2527
Phone 816-232-9874 · Fax 816-364-4283
Mailing address
1616 Weisenborn RdSaint Joseph, MO 64507-2527
Phone 816-232-9874 · Fax 816-364-4283
Authorized official
Matthew J Weishaar
Chief Financial Officer
6157717575
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