Southern Caregivers of de Queen LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SOUTHERN CAREGIVERS OF DE QUEEN LLC

Practice address

211 W Dequeen Ave
De Queen, AR 71832-2809

Phone

(501) 463-9990

Fax

(870) 455-0087

NPI assigned

Dec 15, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Hooper

Title

Quality Director

Phone

(501) 701-9122

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1679285191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717540399",
            "telephone_number": "501-701-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W DEQUEEN AVE",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322809",
            "telephone_number": "501-463-9990",
            "fax_number": "870-455-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CAREGIVERS OF DE QUEEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "HOOPER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "QUALITY DIRECTOR",
        "authorized_official_telephone_number": "501-701-9122"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sevier County Medical Center
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• Ronni Elizabeth Smith-Bagley
• Jessica Megan Smith
• Southwest Arkansas Counseling and Mental Health Center, Inc
• Catherine Stallard, LCSW
• State of Arkansas
• Tamara Lynn Stephens
• Mark R. Stewart, D.M.D.

• All providers in De Queen, AR
• In Home Supportive Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.