Healthcare Provider Details

I. General information

NPI: 1952114001
Provider Name (Legal Business Name): HEART N SOUL HOSPICE ARKANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W MOULTRIE DR
BLYTHEVILLE AR
72315-1812
US

IV. Provider business mailing address

51 CENTURY BLVD STE 110
NASHVILLE TN
37214-3614
US

V. Phone/Fax

Practice location:
  • Phone: 678-333-7880
  • Fax:
Mailing address:
  • Phone: 678-333-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACY LYNELL WOOD
Title or Position: COO
Credential:
Phone: 678-333-7880