Organization · Type 2 NPI

Diversicare of Riverside, LLC

Skilled Nursing Facility · St. Joseph, MO

NPI number 1669887352 Active

Practice location

1616 Weisenborn Rd
St. Joseph, MO 64507-2527

Fax (816) 364-4283

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility	310400000X	042402 (MO)
Skilled Nursing Facility Primary	314000000X	042401 (MO)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

7 other providers at this address

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NPI record

NPI: 1669887352
Entity type: Organization (Type 2)
Issued: Jun 22, 2014
Last updated: Apr 7, 2023
Status: Active
Subpart: Yes of Diversicare Leasing Company Ii, LLC

Other names

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Riverside Place · doing business as
Riverside Place · doing business as

Authorized official

Matthew J Weishaar
Chief Financial Officer
(615) 771-7575

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1669887352

Diversicare of Riverside, LLC's National Provider Identifier is 1669887352, issued on Jun 22, 2014. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in St. Joseph, MO. The record was last updated on Apr 7, 2023.