Healthcare Provider Details

I. General information

NPI: 1003301292
Provider Name (Legal Business Name): LIBCARE OF AR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 W MARKHAM ST STE 105
LITTLE ROCK AR
72205-2187
US

IV. Provider business mailing address

PO BOX 242184
LITTLE ROCK AR
72223-0021
US

V. Phone/Fax

Practice location:
  • Phone: 501-255-0489
  • Fax: 501-255-6559
Mailing address:
  • Phone: 501-255-0489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateAR

VIII. Authorized Official

Name: KATHY BROWN
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 501-255-0489