Provider Demographics
| NPI: | 1427185883 |
|---|---|
| Name: | RSCR INLAND, INC. |
| Entity type: | Organization |
| Organization Name: | RSCR INLAND, INC. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRIVACY OFFICER |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | DEENA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | OMBRES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 502-394-2387 |
| Mailing Address - Street 1: | 9901 LINN STATION RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LOUISVILLE |
| Mailing Address - State: | KY |
| Mailing Address - Zip Code: | 40223-3808 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 800-866-0860 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2662 KEVIN CT |
| Practice Address - Street 2: | |
| Practice Address - City: | RIVERSIDE |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 92506-5117 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 714-537-3252 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-02-27 |
| Last Update Date: | 2008-08-05 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | LTC60345G | Medicaid |