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General NPI Number Information
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NPI Number | 1033874839
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Entity Type | Organization
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Legal Business Name | NEW WAY OF LIFE HOME CARE LLC
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 119 SHADOW OAKS DR
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City | SHERWOOD
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State | AR
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Zip | 72120-6056
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Country | US
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Telephone | 501-992-7644
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Fax |
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Provider Business Mailing Address
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Address Line | 119 SHADOW OAKS DR
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City | SHERWOOD
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State | AR
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Zip | 72120-6056
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Country | US
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Telephone | 501-992-7644
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNQUANETT BRYANT
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Credential |
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Telephone | 501-992-7644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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