Organization Name: | HOSPICE OF SOUTHERN ARKANSAS |
NPI Number: | 1245688050 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRIS LACKNER (DELEGATED OFFICIAL) |
Mailing Address: | 640 Oakland Avenue Helena |
State: | AR US |
Postal Code: | 723421504 |
Phone Number: | 8707534200 |
Fax Number: | 8702923511 |
NPI Enumeration Date: | 06/02/2016 |
NPI Last Update Date: | 06/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | AR5167 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |