Age Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AGE CARE LLC

Practice address

4216 Fox Ridge Dr
Benton, AR 72022-8308

Phone

(479) 968-8279

Fax

(479) 968-4331

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Kerri Couch

Title

Manager

Phone

(479) 968-8279

Specialties & licenses 1

Addresses

Other names 1

• fox ridge estates Doing business as

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497979868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 665",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72018",
            "telephone_number": "479-968-8279",
            "fax_number": "479-968-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 FOX RIDGE DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720228308",
            "telephone_number": "479-968-8279",
            "fax_number": "479-968-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-968-8279",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "fox ridge estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katrina Adams, CMP
• Lashondra Adams
• Ryan Adams
• Matelyn Adaway
• Delores Addie
• Mariah Aguilar, RECOVERY ASSISTANT
• Resa Aguilar, CMP
• Chase Albaugh
• Sarah Albert, LPC
• Kellye Maria Albey, LPC

• Assisted Living Facility in Benton, AR
• Providers in Benton, AR by specialty
• Assisted Living Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.