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General NPI Number Information
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NPI Number | 1720014491
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HOME CARE
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 2000 HARRISON ST SUITE E
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City | BATESVILLE
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State | AR
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Zip | 72501-7442
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Country | US
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Telephone | 870-698-0797
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Fax | 870-698-1057
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Provider Business Mailing Address
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Address Line | 2000 HARRISON ST SUITE E
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City | BATESVILLE
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State | AR
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Zip | 72501-7442
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Country | US
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Telephone | 870-698-0797
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Fax | 870-698-1057
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MRS. SHELLEY GARRETT
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Credential |
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Telephone | 870-698-0797
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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 | 251E00000X
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License Number State | AR
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