CRITTENDEN ADULT CARE SERVICES L.L.C.
Adult Care Home
West Memphis, Arkansas
Provider NPI: 1659595551
Organization Information:Organization Name: CRITTENDEN ADULT CARE SERVICES L.L.C.
Practice Location:
718 E BROADWAY ST WEST MEMPHIS, AR 72301 US
Tel: 870-733-1235 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
718 E BROADWAY ST WEST MEMPHIS, AR 72301 US
Tel: 870-733-1235 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | AR | 120 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
161772765 | AR | 05 | |
164858798 | AR | 05 | |
160110757 | AR | 05 | |
160108752 | AR | 05 | |
160109755 | AR | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin