Arkansas Elder Outreach of Little Rock, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

786 Issued in AR

Legal business name

ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.

Doing business as

Willowbend at Marion

Practice address

101 Brougham Ave
Marion, AR 72364-2505

Phone

(870) 739-3268

Fax

(870) 739-4669

NPI assigned

Aug 4, 2006

Last updated

Feb 22, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Darvin C McMorris

Title

Agent/Designated Official

Phone

(225) 769-7960

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willowbend at Marion Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424563200000",
    "number": "1386652428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BROUGHAM AVE",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642505",
            "telephone_number": "870-739-3268",
            "fax_number": "870-739-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROUGHAM AVE",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642505",
            "telephone_number": "870-739-3268",
            "fax_number": "870-739-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-02-22",
        "status": "A",
        "authorized_official_last_name": "MCMORRIS",
        "authorized_official_first_name": "DARVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AGENT/DESIGNATED OFFICIAL",
        "authorized_official_telephone_number": "225-769-7960",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158268311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willowbend at Marion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darrell Anthony, MHPP
• David Anthony, MHPP
• Blessing Anyanwu, MHPP
• Brandi Nicole Appling
• Lydia Archibald, CASE MANAGER
• Arkansas Extended Care, LLC (Arkansas Community-Based Services)
• Arkansas Home Health Providers-III, LLC (Elite Home Health)
• At Home, LLC
• Maurice Ates
• Lisa Austion

• Skilled Nursing Facility in Marion, AR
• Providers in Marion, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.