MEDICARE: RIVER VALLEY HOME CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	59-00214	OTHER	MEDICA
3	9B93RI	OTHER	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1023014412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER VALLEY HOME CARE INC

Provider Business Mailing Address
First Line	:	916 8TH ST
Second Line	:
City	:	FARMINGTON
State	:	MN
Zip	:	55024-1438
Country	:	US
Telephone Number	:	651-460-4201
Fax Number	:	651-460-4208

Provider Business Practice Location Address
First Line	:	916 8TH ST
Second Line	:
City	:	FARMINGTON
State	:	MN
Zip	:	55024-1438
Country	:	US
Telephone Number	:	651-460-4201
Fax Number	:	651-460-4208

Authorized Official
Title or Position	:	CEO
Name	:	RACHELLE PARISEAU
Credential	:
Telephone Number	:	651-460-4201

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	04/04/2019

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Directions to “RIVER VALLEY HOME CARE INC ” Practice Location

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