=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972641660
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME HEALTH PROFESSIONALS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2007
-----------------------------------------------------
Last Update Date | 02/01/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2222 SPENCE CIR
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72401-7220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-932-7630
-----------------------------------------------------
Fax | 870-932-9422
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 704
-----------------------------------------------------
City | BLYTHEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72316-0704
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-762-1825
-----------------------------------------------------
Fax | 870-762-2299
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | TERESA BARNARD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-762-1825
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | AR4344
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------