Healthcare Provider Details

I. General information

NPI: 1053667022
Provider Name (Legal Business Name): AMERICAN CARE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8116 DEPRIEST RD SUITE 100
MABELVALE AR
72103
US

IV. Provider business mailing address

530 SOUTH RL THORNTON
DALLAS TX
75203
US

V. Phone/Fax

Practice location:
  • Phone: 501-416-6458
  • Fax:
Mailing address:
  • Phone: 214-943-7300
  • Fax: 214-943-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR78660
License Number StateAR

VIII. Authorized Official

Name: MS. PATRICIA ADAMS WILLIAMS
Title or Position: PRESIDENT/FOUNDER
Credential: MBA
Phone: 972-365-6477