Healthcare Provider Details

I. General information

NPI: 1932025913
Provider Name (Legal Business Name): SHIRLEY'S HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

654 N FORREST ST
FORREST CITY AR
72335-2851
US

IV. Provider business mailing address

654 N FORREST ST
FORREST CITY AR
72335-2851
US

V. Phone/Fax

Practice location:
  • Phone: 870-298-6289
  • Fax:
Mailing address:
  • Phone: 870-298-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AISHA SHAVOUNE BRYSON
Title or Position: RN
Credential:
Phone: 870-298-6289