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General NPI Number Information
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NPI Number | 1881892404
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Entity Type | Organization
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Legal Business Name | SOUTHWEST ARKANSAS HOMECARE, LLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 614 S MAIN ST STE 2
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City | NASHVILLE
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State | AR
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Zip | 71852-2706
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Country | US
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Telephone | 870-845-8206
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Fax | 870-451-9741
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-233-5764
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L PROFFITT
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | AR
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AR4467
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License Number State | AR
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