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General NPI Number Information
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NPI Number | 1033789482
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Entity Type | Organization
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Legal Business Name | COMMUNITY CAREGIVERS LLC
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 915 OAK ST STE 1005
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City | CONWAY
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State | AR
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Zip | 72032-4371
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Country | US
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Telephone | 501-932-1897
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Fax | 501-300-5871
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Provider Business Mailing Address
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Address Line | 915 OAK ST STE 1005
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City | CONWAY
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State | AR
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Zip | 72032-4371
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Country | US
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Telephone | 501-932-1897
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Fax | 501-300-5871
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Authorized Official
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Title or Position | RN
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Name | ERIKA BLACK
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Credential | RN
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Telephone | 501-428-6525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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