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General NPI Number Information
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NPI Number | 1497071849
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Entity Type | Organization
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Legal Business Name | BRIDGE OF FAITH HOSPICE & PALLIATIVE CARE, LLC
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | 657 OAKLAND AVE
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City | HELENA
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State | AR
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Zip | 72342-1503
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Country | US
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Telephone | 870-572-4333
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Fax | 870-572-4433
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Provider Business Mailing Address
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Address Line | PO BOX 2522
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City | WEST HELENA
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State | AR
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Zip | 72390-0522
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Country | US
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Telephone | 870-572-4333
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Fax | 870-572-4433
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Authorized Official
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Title or Position | OWNER
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Name | MR. WENDELL S. BRANDON
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Credential |
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Telephone | 870-572-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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