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General NPI Number Information
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NPI Number | 1346462918
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY IN HOME SERVICES
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 104 WASHINGTON ST STE C
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City | DONIPHAN
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State | MO
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Zip | 63935-1780
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Country | US
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Telephone | 573-996-2770
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Fax | 573-996-4233
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Provider Business Mailing Address
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Address Line | 104 WASHINGTON ST STE C
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City | DONIPHAN
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State | MO
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Zip | 63935-1780
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Country | US
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Telephone | 573-996-2770
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Fax | 573-996-4233
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHY LAOMA WILSON
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Credential |
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Telephone | 573-996-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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