Healthcare Provider Details

I. General information

NPI: 1669079315
Provider Name (Legal Business Name): KRM MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 OUACHITA AVE
HOT SPRINGS AR
71901-5129
US

IV. Provider business mailing address

PO BOX 1622
HOT SPRINGS AR
71902-1622
US

V. Phone/Fax

Practice location:
  • Phone: 501-204-4497
  • Fax:
Mailing address:
  • Phone: 512-239-8415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN ROBERTS-MITCHELL
Title or Position: OWNER
Credential:
Phone: 512-239-8415