Provider Demographics
NPI:1063742708
Name:RC OPERATORS, LLC (D.B.A. WILLOW TERRACE)
Entity type:Organization
Organization Name:RC OPERATORS, LLC (D.B.A. WILLOW TERRACE)
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:RINGKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LNHA
Authorized Official - Phone:215-951-8656
Mailing Address - Street 1:505 MARLBORO ROAD
Mailing Address - Street 2:
Mailing Address - City:WOOD-RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075
Mailing Address - Country:US
Mailing Address - Phone:201-635-1195
Mailing Address - Fax:
Practice Address - Street 1:ONE PENN BOULEVARD
Practice Address - Street 2:PENN TOWER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4206
Practice Address - Country:US
Practice Address - Phone:215-951-8656
Practice Address - Fax:215-849-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA072102314000000X
PA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024679250001Medicaid
PA396129Medicare UPIN
PA1024679250001Medicaid