MEDICARE: PLAY, LOVE, & WORK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	08-17P	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1093722415	OTHER	AR	BCBS AND MEDICARE BUT DON'T KNOW WHICH OF THE ABOVE-NURSING HOMES ON SITE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760779896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAY, LOVE, & WORK LLC

Provider Business Mailing Address
First Line	:	1208 RICHARD ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-5621
Country	:	US
Telephone Number	:	870-918-5989
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 RICHARD ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-5621
Country	:	US
Telephone Number	:	870-918-5989
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	MS. CATHERINE L COON
Credential	:	LP, RPT
Telephone Number	:	870-918-5989

Provider Enumeration Date	:	07/11/2011
Last Update Date	:	07/11/2011

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Directions to “PLAY, LOVE, & WORK LLC ” Practice Location

Language	Start Address	Practice Location

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