Healthcare Provider Details

I. General information

NPI: 1538961008
Provider Name (Legal Business Name): MRS. LANEVA ELIZABETH EADS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

553 JACK MOUNTAIN RD
HOT SPRINGS AR
71913-1203
US

IV. Provider business mailing address

553 JACK MOUNTAIN RD
HOT SPRINGS AR
71913-1203
US

V. Phone/Fax

Practice location:
  • Phone: 501-293-5012
  • Fax:
Mailing address:
  • Phone: 501-293-5012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: