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General NPI Number Information
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NPI Number | 1871134825
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Entity Type | Organization
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Legal Business Name | JUST SPREADING LOVE SENIOR CARE LLC
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 1411 N. PITTSBURG AVENUE
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City | RUSSELLVILLE
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State | AR
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Zip | 72801
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Country | US
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Telephone | 479-518-2383
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 11292 RUSSELLVILLE
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City | RUSSELLVILLE
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State | AR
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Zip | 72812
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Country | US
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Telephone | 479-518-2383
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Fax |
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Authorized Official
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Title or Position | OWNER-AUTHORIZED OFFICIAL
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Name | LISA R. JOHNSON
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Credential |
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Telephone | 479-518-2383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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