NPIMap

Organization Active NPI

Ccla 9 LLC

Doing business as Riverview Health & Rehab Center

  • Skilled Nursing Facility
  • Detroit, MI
National Provider Identifier
1295018745
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CCLA 9 LLC
Doing business as
Riverview Health & Rehab Center
Practice address
7733 E Jefferson Ave
Detroit, MI 48214-3707
Phone
(313) 499-4100
Fax
(313) 499-4934
NPI assigned
Sep 21, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tim Kamego
Title
Director of Operations
Phone
(586) 563-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

7733 E Jefferson Ave
Detroit, MI 48214-3707

Mailing address

PO Box 250459
Franklin, MI 48025-0459
Phone (586) 563-1500

Other identifiers 2

IdentifierTypeStateIssuer
60-1950507MedicaidMI
1851691844OtherNPI

Other names 1

  • Riverview Health & Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120117000189 WI Part A Provider - Skilled Nursing Facility 3476735200 Practice locations: Detroit, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295018745. Details of each certification follow.

Skilled nursing facility certification: CCN 235659

Legal name
CCLA 9 LLC
Doing business as
RIVERVIEW HEALTH & REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 4, 2012
Last certification
Apr 9, 2025
Beds
203
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Riverview Health/CCLA9 LLC
Organization structure
LLCProprietary
Incorporated
Sep 12, 2009 in MI
Enrollment address
7733 E Jefferson Ave
Detroit, MI 48214-3707
Nursing home name
RIVERVIEW HEALTH & REHAB CENTER

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Riverview Health & Rehab CenterCCN 235659 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 4, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
203149.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Ccla 9 LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

31100 Telegraph Rd
Ste 250
Bingham Farms, MI 48025

7733 E Jefferson Ave
#100
Detroit, MI 48214
Phone (313) 432-1224

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Timothy Kamego Individual Contracted Managing EmployeeDirector of Operations Sep 12, 2009 100%
Corporate DirectorDirector of Operations Oct 4, 2012 100%

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1295018745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250459",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480250459",
            "telephone_number": "586-563-1500",
            "fax_number": "568-563-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143707",
            "telephone_number": "313-499-4100",
            "fax_number": "313-499-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCLA 9 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "KAMEGO",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "586-563-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60-1950507",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1851691844",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverview Health & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.