Provider Demographics
NPI:1073408118
Name:RIVERBREEZE ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:RIVERBREEZE ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-338-5548
Mailing Address - Street 1:4414 E BUCKEYE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-7301
Mailing Address - Country:US
Mailing Address - Phone:509-338-5548
Mailing Address - Fax:
Practice Address - Street 1:4414 E BUCKEYE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-7301
Practice Address - Country:US
Practice Address - Phone:509-338-5548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home