Provider Demographics
NPI:1114387446
Name:RIALTO HEALTHCARE LLC
Entity type:Organization
Organization Name:RIALTO HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:MOSHE
Authorized Official - Last Name:RASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-445-6636
Mailing Address - Street 1:1267 WILLIS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0400
Mailing Address - Country:US
Mailing Address - Phone:818-309-2454
Mailing Address - Fax:
Practice Address - Street 1:1471 S RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-7703
Practice Address - Country:US
Practice Address - Phone:909-877-1361
Practice Address - Fax:909-877-8912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility