Wynne Elder Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

WYNNE ELDER CARE LLC

Practice address

2019 E Broadway St
Forrest City, AR 72335-7881

Phone

(870) 633-1977

Fax

(870) 633-1977

NPI assigned

Sep 14, 2015

Last updated

Sep 23, 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

Mrs. Margaret Paulette McClanahan, PT

Title

Incorporator/Organizer

Phone

(870) 208-5452

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1720456320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723961420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 E BROADWAY ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723357881",
            "telephone_number": "870-633-1977",
            "fax_number": "870-633-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNE ELDER CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "MCCLANAHAN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "PAULETTE",
        "authorized_official_title_or_position": "INCORPORATOR/ORGANIZER",
        "authorized_official_telephone_number": "870-208-5452",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AR",
            "license": "PT820",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashunda Winfrey, CM/ACTIVITY THERP.
• Eric R Wood, CRNA
• Tamikak Woodard, CASE MANAGER
• Woodridge of Forrest City, LLC (Perimeter Behavioral of Forrest City)
• Alisha Nichol Wyatt, M.D.
• Nina R Young
• Young's for Transit LLC
• Youngs One Stop Transport LLC

• In Home Supportive Care Agency in Forrest City, AR
• Providers in Forrest City, AR by specialty
• In Home Supportive Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.