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General NPI Number Information
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NPI Number | 1376366286
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Entity Type | Organization
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Legal Business Name | ENSURE HOME CARE OF ARKANSAS LLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 400 W CAPITOL AVE STE 1700
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City | LITTLE ROCK
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State | AR
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Zip | 72201-3438
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Country | US
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Telephone | 414-704-9031
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Fax | 704-879-3991
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Provider Business Mailing Address
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Address Line | PO BOX 480036
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City | CHARLOTTE
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State | NC
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Zip | 28269-5300
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Country | US
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Telephone | 414-704-9031
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHNNA SCOTT
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Credential |
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Telephone | 414-704-9031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 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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