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General NPI Number Information
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NPI Number | 1922671577
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Entity Type | Organization
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Legal Business Name | DEVELOPMENT RESOURCE SERVICE LLC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 525 N 16TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-3319
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Country | US
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Telephone | 870-912-1206
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Fax |
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Provider Business Mailing Address
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Address Line | 525 N 16TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-3319
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Country | US
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Telephone | 870-912-1206
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHINEQUA WHITE
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Credential |
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Telephone | 901-265-2005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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