NPIMap

Organization Active NPI

Olivia'S Senior Home Care

  • In Home Supportive Care Agency
  • Monticello, AR
National Provider Identifier
1508466640
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
OLIVIA'S SENIOR HOME CARE
Practice address
111 E Gaines St
Monticello, AR 71655-4901
Phone
(479) 285-5241
NPI assigned
Oct 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Vanessa Laranjo Brown, CEO
Title
Administrator
Phone
(479) 285-5241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

111 E Gaines St
Monticello, AR 71655-4901

Mailing address

111 E Gaines St
Monticello, AR 71655-4901
Phone (479) 285-5241

Other identifiers 1

IdentifierTypeStateIssuer
236911757MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Olivia'S Senior Home Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1508466640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E GAINES ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554901",
            "telephone_number": "479-285-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E GAINES ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554901",
            "telephone_number": "479-285-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVIA'S SENIOR HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "LARANJO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-285-5241",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236911757",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.