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General NPI Number Information
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NPI Number | 1316463730
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Entity Type | Organization
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Legal Business Name | ARKANSAS HOME CARE ASSISTANCE, LLC
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3955 CENTRAL AVE STE 4
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City | HOT SPRINGS NATIONAL PARK
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State | AR
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Zip | 71913
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Country | US
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Telephone | 501-463-9425
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Fax | 501-463-9426
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Provider Business Mailing Address
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Address Line | 3955 CENTRAL AVE STE 4
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City | HOT SPRINGS NATIONAL PARK
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State | AR
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Zip | 71913-7290
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Country | US
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Telephone | 501-463-9425
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Fax | 501-463-9426
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Authorized Official
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Title or Position | CO-OWNER
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Name | STACEY RENEE PHILYAW
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Credential |
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Telephone | 501-463-9425
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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 | AR
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