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General NPI Number Information
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NPI Number | 1235788829
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Entity Type | Organization
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Legal Business Name | CHK LLC
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 3418 MAIN ST STE 100
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City | BRYANT
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State | AR
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Zip | 72022-6001
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Country | US
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Telephone | 501-777-9500
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Fax | 501-481-8926
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Provider Business Mailing Address
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Address Line | 3418 MAIN ST STE 100
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City | BRYANT
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State | AR
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Zip | 72022-6001
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Country | US
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Telephone | 501-777-9500
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Fax | 501-481-8926
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Authorized Official
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Title or Position | OWNER
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Name | KRISTI GWATNEY
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Credential | RN
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Telephone | 501-777-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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