Healthcare Provider Details
I. General information
NPI: 1235075805
Provider Name (Legal Business Name): ICAN HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
207 PROGRESS WAY STE 112
BRYANT AR
72022-8810
US
IV. Provider business mailing address
207 PROGRESS WAY STE 112
BRYANT AR
72022-8810
US
V. Phone/Fax
- Phone: 501-451-5545
- Fax:
- Phone: 501-451-5545
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TALAYIA
J
JOHNSON
Title or Position: FOUNDER/CEO
Credential: EDD, MSN, RN
Phone: 501-451-5545