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Organization

KATHY LAOMA WILSON

Active
Other names
River Valley In Home Services
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHY LAOMA WILSON (OWNER)
(573) 996-2770
Entity
Organization

Contact information

Practice address
104 C WASHINGTON STREET, DONIPHAN, MO 63935-1780
(573) 996-2770
(573) 996-4233
Mailing address
104 C WASHINGTON STREET, DONIPHAN, MO 63935-1780
(573) 996-2770
(573) 996-4233

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008057
MO
Enumeration date
03/14/2007
Last updated
08/22/2020
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