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General NPI Number Information
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NPI Number | 1689654337
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Entity Type | Organization
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Legal Business Name | AREA AGENCY ON AGING OF SOUTHEAST ARKANSAS INC
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 709 E 8TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71601-5010
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Country | US
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Telephone | 870-543-6300
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Fax | 870-534-2152
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Provider Business Mailing Address
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Address Line | PO BOX 8569
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City | PINE BLUFF
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State | AR
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Zip | 71611-8569
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Country | US
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Telephone | 870-543-6300
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Fax | 870-534-2152
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KATHY C TYNES
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Credential |
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Telephone | 870-543-6300
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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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