| Organization Name: | RIVERVIEW ADULT DAY & HEALTH CENTER INC. |
| NPI Number: | 1053744300 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES MILTON JACKSON (OWNER) |
| Mailing Address: | 18712 Quarry St Riverview |
| State: | MI US |
| Postal Code: | 481934527 |
| Phone Number: | 7345605901 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2013 |
| NPI Last Update Date: | 08/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 6802063993 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |