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General NPI Number Information
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NPI Number | 1841485893
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Entity Type | Individual
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Provider Name | MAHALA KATHERINE HAYES MHPP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 4400 SHUFFIELD DR
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7100
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Country | US
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Telephone | 501-686-9318
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Fax | 501-686-9618
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Provider Business Mailing Address
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Address Line | PO BOX 250337
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City | LITTLE ROCK
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State | AR
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Zip | 72225-0337
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Country | US
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Telephone | 501-686-9318
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Fax | 501-686-9618
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | AR
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