Organization
A RIVER'S JOURNEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATRENA M. THOMAS MSW, MSM (CHIEF EXECUTIVE OFFICER)
(804) 502-5840
Entity
Organization
Contact information
Practice address
1821 N PEARL ST, JACKSONVILLE, FL 32206-3663
(804) 502-5840
(904) 485-8541
Mailing address
PO BOX 77581, JACKSONVILLE, FL 32226-7581
(804) 502-5840
(904) 485-8541
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
02/20/2015
Last updated
01/29/2021
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