River Valley Supportive Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RIVER VALLEY SUPPORTIVE LIVING LLC

Practice address

1975 E Court St
Kankakee, IL 60901-2781

Phone

(815) 936-1000

NPI assigned

Jan 11, 2016

Organization subpart

No

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

Authorized official

Name

Marc Siebzener

Title

Manager

Phone

(847) 452-6804

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1477919132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597665",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606597665",
            "telephone_number": "847-452-6804",
            "fax_number": "773-305-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012781",
            "telephone_number": "815-936-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER VALLEY SUPPORTIVE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "SIEBZENER",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-452-6804"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Maria Richardson-Belgrave, CNP
• Julie Richardson
• Kristen M Richardson, PHARMD
• Nathan David Rieder, MOT OTR/L
• Rincon Family Services
• River Valley Supportive Living Residence LLC
• Riverside Emergency Physicians, LLC
• Riverside Health System
• Riverside Health System
• Riverside Medical Center

• Assisted Living Facility in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.