Organization
RIVER VALLEY IN HOME SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY LAOMA WILSON (OWNER)
(573) 996-2770
Entity
Organization
Contact information
Practice address
104 WASHINGTON ST STE C, DONIPHAN, MO 63935-1780
(573) 996-2770
(573) 996-4233
Mailing address
104 WASHINGTON ST STE C, 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
—
286197108
—
MO
Enumeration date
05/03/2007
Last updated
07/21/2008
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