Healthcare Provider Details
I. General information
NPI: 1891427829
Provider Name (Legal Business Name): EXCLUSIVE HELPING HANDS INDEPENDENT ASSISTANCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/28/2022
Last Update Date: 10/15/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6200 COLONEL GLENN RD APT 244
LITTLE ROCK AR
72204-7706
US
IV. Provider business mailing address
405 W 24TH ST
NORTH LITTLE ROCK AR
72114-2111
US
V. Phone/Fax
- Phone: 281-662-9677
- Fax:
- Phone: 281-662-9677
- Fax: 281-662-9677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ANISSA
PERRY
Title or Position: OWNER
Credential: MA
Phone: 281-662-9677