Provider Demographics
NPI:1306118641
Name:RIVER BEND SERVICES, INC.
Entity type:Organization
Organization Name:RIVER BEND SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-654-3941
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MS
Mailing Address - Zip Code:39098-0009
Mailing Address - Country:US
Mailing Address - Phone:601-654-3941
Mailing Address - Fax:601-654-3895
Practice Address - Street 1:3696 RIVER BEND ROAD
Practice Address - Street 2:
Practice Address - City:LENA
Practice Address - State:MS
Practice Address - Zip Code:39094
Practice Address - Country:US
Practice Address - Phone:601-654-3941
Practice Address - Fax:601-654-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770465Medicaid
MS00770520Medicaid
MS08682229Medicaid