RIVER CROSSING OF ROCKFORD (ROCKFORD NH LLC) NPI 1700329240

Skilled Nursing Facility in Rockford, IL

NPI 1700329240 Organization Skilled Nursing Facility CLIA Number 14D2176806 CLIA Certificate of Waiver

About RIVER CROSSING OF ROCKFORD (ROCKFORD NH LLC)

River Crossing Of Rockford (rockford Nh Llc) is a provider established in Rockford, Illinois specializing in skilled nursing facility. The NPI number of River Crossing Of Rockford (rockford Nh Llc) is 1700329240 and was assigned on December 2016. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated June 2021. The provider's is doing business as River Crossing Of Rockford. The authorized official of this NPI record is James Bolick (President)

The CLIA number of River Crossing Of Rockford is 14D2176806 registered as a "skilled nursing/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to River Crossing Of Rockford to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1700329240

Provider NameRIVER CROSSING OF ROCKFORD (ROCKFORD NH LLC)
Provider Location Address1660 S MULFORD RD ROCKFORD, IL 61108
Provider Mailing Address1660 S MULFORD RD ROCKFORD, IL 61108
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameRIVER CROSSING OF ROCKFORD
Other Name TypeDoing Business As (3)
Enumeration Date12-01-2016
Last Update Date06-25-2021


Primary Taxonomy

Taxonomy Code314000000X
ClassificationSkilled Nursing Facility
TypeNursing & Custodial Care Facilities
Taxonomy Description(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Business Address

RIVER CROSSING OF ROCKFORD
1660 S MULFORD RD
ROCKFORD, IL
ZIP 61108
Phone: (815) 397-8700
Fax: (815) 397-4880

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Mailing Address

RIVER CROSSING OF ROCKFORD
1660 S MULFORD RD
ROCKFORD, IL
ZIP 61108
Phone:



Authorized Official

Authorized Official Name JAMES BOLICK
Authorized Official TitlePRESIDENT
Authorized Official Phone(212) 649-9705

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1700329240 is:

CLIA Number14D2176806
Facility TypeSKILLED NURSING/NURSING FACILITY
Certificate TypeCertificate of Waiver

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306841135ROSEWOOD CARE CENTER, INC OF ROCKFORD
Organization
Skilled Nursing Facility1660 S MULFORD RD
ROCKFORD, IL 61108
(815) 397-8700
1003003765BRAVO CARE OF ROCKFORD INC
Organization
Skilled Nursing Facility1660 S MULFORD RD
ROCKFORD, IL 61108
(815) 397-8700
1467099895 BRADLEY PAUL CARY MPT
Individual
Physical Therapist1660 S MULFORD RD
ROCKFORD, IL 61108
(815) 397-8700

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.