Healthcare Provider Details

I. General information

NPI: 1669683033
Provider Name (Legal Business Name): COMMUNITIES HOME HEALTH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 WEST MAPLE
SPRINGDALE AR
72765
US

IV. Provider business mailing address

409 W MAPLE
SPRINGDALE AR
72765
US

V. Phone/Fax

Practice location:
  • Phone: 479-751-1601
  • Fax: 479-750-6501
Mailing address:
  • Phone: 479-751-1601
  • Fax: 479-750-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberAR4234
License Number StateAR

VIII. Authorized Official

Name: SHAWN A BARNETT
Title or Position: CFO
Credential:
Phone: 479-757-4011