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General NPI Number Information
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NPI Number | 1104298454
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Entity Type | Organization
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Legal Business Name | HAYES' HOME CARE
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 939 E SULLENBERGER AVE
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City | MALVERN
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State | AR
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Zip | 72104-4409
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Country | US
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Telephone | 501-467-2108
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Fax |
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Provider Business Mailing Address
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Address Line | 939 E SULLENBERGER AVE
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City | MALVERN
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State | AR
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Zip | 72104-4409
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA HAYES
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Credential | LPN
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Telephone | 501-467-2108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | L028906
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License Number State | AR
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