Healthcare Provider Details

I. General information

NPI: 1073204475
Provider Name (Legal Business Name): PLUM, PEACE LOVE UNDERSTANDING MERCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 W BROADWAY ST
FORREST CITY AR
72335-3619
US

IV. Provider business mailing address

208 W BROADWAY ST
FORREST CITY AR
72335-3619
US

V. Phone/Fax

Practice location:
  • Phone: 870-514-4954
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. HOWARD SMITH II
Title or Position: CEO
Credential:
Phone: 870-514-4954