| Organization Name: | MENA MEDICAL CENTER HOSPICE, LLC |
| NPI Number: | 1265516587 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD D. STELLY (PRESIDENT) |
| Mailing Address: | 1106 Mena St Mena |
| State: | AR US |
| Postal Code: | 719534252 |
| Phone Number: | 4793941134 |
| Fax Number: | 4793942056 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 07/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | AR4411 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |