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Organization

RIVERWAYS SUPPORT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARRIE LYNN WOMACK (LEAD OFFICE ASSISTANT)
(417) 256-0191
Entity
Organization

Contact information

Practice address
114 E MAIN ST, WEST PLAINS, MO 65775-3556
(417) 256-0191
Mailing address
114 E MAIN ST, WEST PLAINS, MO 65775-3556
(417) 256-0191

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
294954102
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
294954102
MO
Enumeration date
06/04/2008
Last updated
06/04/2008
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