Provider Demographics
NPI:1447017371
Name:RIVERSIDE HOME CARE, LLC
Entity type:Organization
Organization Name:RIVERSIDE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:KERR-TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-386-9085
Mailing Address - Street 1:972 COUNTRYRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-4805
Mailing Address - Country:US
Mailing Address - Phone:513-386-9085
Mailing Address - Fax:513-513-1308
Practice Address - Street 1:972 COUNTRYRIDGE LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-4805
Practice Address - Country:US
Practice Address - Phone:513-386-9085
Practice Address - Fax:513-513-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care