Provider Demographics
NPI:1144487828
Name:CADIA HEALTHCARE RIVERSIDE
Entity type:Organization
Organization Name:CADIA HEALTHCARE RIVERSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LITWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-731-2500
Mailing Address - Street 1:700 W LEA BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2500
Mailing Address - Country:US
Mailing Address - Phone:302-765-4400
Mailing Address - Fax:
Practice Address - Street 1:700 W LEA BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2500
Practice Address - Country:US
Practice Address - Phone:302-765-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1144487828Medicaid
DE1144487828Medicaid