- Enrollment id
- O20250819002282
- Enrollment state
- IL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1053100917
- Multiple npi flag
- N
- Ccn
- 145334
- Associate id
- 7315446051
- Organization name
- RIVAYA CARE OF DES PLAINES LLC
- Doing business as name
- RIVAYA CARE OF DES PLAINES
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- RIVAYA CARE OF DES PLAINES
- Address line 1
- 9300 W BALLARD RD
- City
- DES PLAINES
- State
- IL
- Zip code
- 600164904