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General NPI Number Information
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NPI Number | 1851259493
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Entity Type | Organization
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Legal Business Name | 1ST HAVEN SUPPORTIVE CARE
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 907 VALLEY CREEK PT
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-3742
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Country | US
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Telephone | 501-235-0909
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Fax | 501-299-3822
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Provider Business Mailing Address
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Address Line | 907 VALLEY CREEK PT
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-3742
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Country | US
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Telephone | 501-235-0909
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Fax | 501-299-3822
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Authorized Official
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Title or Position | PRESIDENT
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Name | JERILYN SWALVE WASSON
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Credential | LPE
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Telephone | 501-425-0472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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