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General NPI Number Information
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NPI Number | 1952525784
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Entity Type | Organization
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Legal Business Name | WHITE RIVER AREA AGENCY ON AGING,INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 3998 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-4107
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Country | US
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Telephone | 870-612-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2637
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City | BATESVILLE
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State | AR
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Zip | 72503-2637
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Country | US
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Telephone | 870-612-3000
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TED HALL
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Credential |
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Telephone | 870-612-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AR3459
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 06-014
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | AR3459
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MG01287
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License Number State | AR
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