NPI 1720017833 · live from the CMS NPI Registry
State Of Arkansas
Hospice Care, Community Based in Russellville, AR. National Provider Identifier 1720017833, active.
NPI record
| NPI | 1720017833 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospice Care, Community Based 251G00000X |
| Practice location | 404 El Paso, Northwest Regional Office, Russellville, AR 72801 |
| Practice phone | 501-661-2698 |
| Mailing address | 5800 West 10th St, Suite 300, Little Rock, AR 72204 |
| Enumerated | July 1, 2006 |
| Last updated | October 9, 2012 |
| Authorized official | Gayla Lanum, Hospice Director |
| Other names | Arkansas Department Of Health Hospice 3 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based primary | 251G00000X | AR3629 (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.