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General NPI Number Information
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NPI Number | 1912045899
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Entity Type | Organization
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Legal Business Name | HOSPICE HOME CARE OF PINE BLUFF, LLC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 7197 SHERIDAN RD STE 113
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City | WHITE HALL
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State | AR
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Zip | 71602-3261
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Country | US
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Telephone | 870-540-0727
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Fax | 501-540-0072
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Provider Business Mailing Address
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Address Line | 2200 SOUTH BOWMAN RD.
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4136
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Country | US
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Telephone | 501-558-4100
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Fax | 501-221-0687
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | KRISTI KENSLOW
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Credential |
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Telephone | 501-558-4122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | AR4338
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License Number State | AR
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