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General NPI Number Information
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NPI Number | 1184495475
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Entity Type | Organization
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Legal Business Name | LJ HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 1636 HIGDON FERRY RD
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6912
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Country | US
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Telephone | 501-229-3368
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Fax | 501-287-2771
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Provider Business Mailing Address
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Address Line | 411 WOODLAND CV
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City | MALVERN
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State | AR
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Zip | 72104-4864
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Country | US
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Telephone | 501-229-3368
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Fax | 501-287-2771
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Authorized Official
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Title or Position | OWNER
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Name | LACY HOLLEY
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Credential |
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Telephone | 501-229-3368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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