Provider Demographics
NPI:1053344192
Name:COMMUNITY HOME HEALTH CARE OF AR
Entity type:Organization
Organization Name:COMMUNITY HOME HEALTH CARE OF AR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:870-856-2671
Mailing Address - Street 1:PO BOX 418
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542
Mailing Address - Country:US
Mailing Address - Phone:870-856-2671
Mailing Address - Fax:870-856-2670
Practice Address - Street 1:2315 HWY 62/412
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542
Practice Address - Country:US
Practice Address - Phone:870-856-2671
Practice Address - Fax:870-856-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR251E00000X
ARAR4286251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
4286OtherAR DEPT OF HEALTH
AR162745514Medicaid
AR4286OtherAR DEPT OF HEALTH
AR4286OtherAR DEPT OF HEALTH
AR162745514Medicaid