Healthcare Provider Details
I. General information
NPI: 1831948678
Provider Name (Legal Business Name): NONNA'S CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1142 HIGHWAY 71 S STE D
MENA AR
71953-8078
US
IV. Provider business mailing address
PO BOX 12
MENA AR
71953-0012
US
V. Phone/Fax
- Phone: 479-391-2424
- Fax: 479-227-5360
- Phone: 479-391-2424
- Fax: 479-227-5360
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TONYA
L
CHAMBERS
Title or Position: OWNER
Credential: PMHNP
Phone: 479-216-1172