Healthcare Provider Details

I. General information

NPI: 1831872662
Provider Name (Legal Business Name): CARECO HOME CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 W COMMERCIAL DR STE B3
NORTH LITTLE ROCK AR
72116-8073
US

IV. Provider business mailing address

6834 CANTRELL RD # 2099
LITTLE ROCK AR
72207-4135
US

V. Phone/Fax

Practice location:
  • Phone: 501-557-3888
  • Fax: 501-333-9192
Mailing address:
  • Phone: 501-557-3888
  • Fax: 501-333-9192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LATOSHA MARTIN
Title or Position: CLIENT CARE MANAGER
Credential:
Phone: 501-557-3888