Provider Demographics
NPI:1528062882
Name:RIVERSIDE LANDING NURSING AND REHABILITATION, INC.
Entity type:Organization
Organization Name:RIVERSIDE LANDING NURSING AND REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-727-3996
Mailing Address - Street 1:2875 CENTER RD STE 6
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-2319
Mailing Address - Country:US
Mailing Address - Phone:216-772-1105
Mailing Address - Fax:
Practice Address - Street 1:856 S RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MC CONNELSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-9102
Practice Address - Country:US
Practice Address - Phone:740-962-5303
Practice Address - Fax:740-962-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1595332BP3500X
OH1595N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5469410001Medicare NSC
OH366130Medicare ID - Type Unspecified