Organization
RIVER VALLEY PCA SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME NICHOLE KUMMER (ADMINISTRATOR/CEO)
(651) 460-4201
Entity
Organization
Contact information
Practice address
916 8TH STREET, FARMINGTON, MN 55024
(651) 460-4201
(651) 460-4208
Mailing address
916 8TH STREET, FARMINGTON, MN 55024
(651) 460-4201
(651) 460-4208
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
MN
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181670
UCARE PROVIDER NUMBER
MN
05
—
406323600
—
MN
Enumeration date
01/24/2007
Last updated
12/16/2021
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