| NPI | 1558487017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CECIL WATTERS Accountant 870-793-6943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: AR 08464-07) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: AR 08464-07) |
| 235Z00000X Speech-Language Pathologist, (Licence: AR 08464-07) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: AR 08464) | |
| 251B00000X Case Management (Licence: AR 08464-07) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-05-21 |