=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346105061
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHERISHED MOMENTS HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2025
-----------------------------------------------------
Last Update Date | 12/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7507 PEACH BLOSSOM AVE
-----------------------------------------------------
City | BENTON
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72019-7956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-247-8747
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7507 PEACH BLOSSOM AVE
-----------------------------------------------------
City | BENTON
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72019-7956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-247-8747
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE OWNER
-----------------------------------------------------
Name | MRS. CARLA BUTLER
-----------------------------------------------------
Credential | CEO
-----------------------------------------------------
Telephone | 501-247-8747
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------