Provider Demographics
NPI:1992581961
Name:BOSSIER RIVERVIEW LLC
Entity type:Organization
Organization Name:BOSSIER RIVERVIEW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:H
Authorized Official - Last Name:PARKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-709-1408
Mailing Address - Street 1:4820 MEDICAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4562
Mailing Address - Country:US
Mailing Address - Phone:318-747-1857
Mailing Address - Fax:318-741-1259
Practice Address - Street 1:4820 MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4562
Practice Address - Country:US
Practice Address - Phone:318-747-1857
Practice Address - Fax:318-741-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility