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General NPI Number Information
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NPI Number | 1073390084
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Entity Type | Organization
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Legal Business Name | JONES RISING STAR
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 800 CLEMENT RD
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2885
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Country | US
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Telephone | 870-635-7967
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Fax |
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Provider Business Mailing Address
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Address Line | 800 CLEMENT RD
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2885
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Country | US
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Telephone | 870-635-7967
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BEVERLY JONES
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Credential | MBA, MSN, RN
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Telephone | 870-635-7967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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