Healthcare Provider Details
I. General information
NPI: 1922710920
Provider Name (Legal Business Name): PLUM, PEACE LOVE UNDERSTANDING MERCY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2022
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 THOMPSON AVE
WEST MEMPHIS AR
72301-3257
US
IV. Provider business mailing address
PO BOX 5147
WEST MEMPHIS AR
72303-5147
US
V. Phone/Fax
- Phone: 870-600-4414
- Fax:
- Phone: 870-600-4414
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HOWARD
C.
SMITH
II
Title or Position: PRESIDENT/CEO
Credential: PH.D., ED.S.,
Phone: 870-600-4414