Healthcare Provider Details

I. General information

NPI: 1770227951
Provider Name (Legal Business Name): AT HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MAPLE ST
MARION AR
72364-2014
US

IV. Provider business mailing address

15 MAPLE ST
MARION AR
72364-2014
US

V. Phone/Fax

Practice location:
  • Phone: 501-697-5303
  • Fax: 870-277-0905
Mailing address:
  • Phone: 501-697-5303
  • Fax: 870-277-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TERRA BOYKIN
Title or Position: PRESIDENT/ADMIN
Credential:
Phone: 501-697-5303