Provider Demographics
NPI:1376927640
Name:RIVER HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:RIVER HEALTH SYSTEMS LLC
Other - Org Name:RIGHT AT HOME OF THE RIVERCITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:QUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:304-453-4663
Mailing Address - Street 1:711 C STREET
Mailing Address - Street 2:PO BOX 1450
Mailing Address - City:CEREDO
Mailing Address - State:WV
Mailing Address - Zip Code:25507
Mailing Address - Country:US
Mailing Address - Phone:304-453-4663
Mailing Address - Fax:304-453-1103
Practice Address - Street 1:711 C STREET
Practice Address - Street 2:
Practice Address - City:CEREDO
Practice Address - State:WV
Practice Address - Zip Code:25507
Practice Address - Country:US
Practice Address - Phone:304-453-4663
Practice Address - Fax:304-453-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2221-2005253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care