State of Arkansas
Organization Active NPI Home Health Agency · Monticello, AR
NPI 1730199787 · NPPES record last updated Jul 2, 2008
Key facts
- NPI
- 1730199787
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- AR3985 (AR)
- Legal business name
- STATE OF ARKANSAS
- Practice address
- 600 C Highway 425 N
Drew County Health Unit
Monticello, AR 71655-5732 - Phone
- (870) 367-6234
- Fax
- (870) 367-9130
- NPI assigned
- Aug 9, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- STATE OF ARKANSAS
Authorized official
- Name
- Marilyn Evans, RN
- Title
- Home Health Administrator
- Phone
- (501) 661-2540
Corporate family (same tax ID) 13
Member of 1
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Aug 1, 2016 | Change of Ownership |
Centerwell Home Health |
National Provider Directory
- Tax ID family
- Centerwell Home Health
- Part of
- State of Arkansas
Locations
600C Highway 425 N
Monticello, AR 71655
Phone (870) 367-6234
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | AR3985 | AR | Yes |
Addresses
Primary practice location
600 C Highway 425 N
Drew County Health Unit
Monticello, AR 71655-5732
Mailing address
5800 West 10TH Street
Suite 300
Little Rock, AR 72204-1764
Phone (501) 661-2614
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104312514 | Medicaid | AR |
Other names
- Drew County Health Unit
Other providers in Monticello, AR
- Anita Mariette Spence
- Christopher Spencer
- Latasha Renee Spencer
- Sydney McKay Sprawls
- Wanda Stanley
- Jennie Elizabeth Staten
- Dabney Jane Stell
- Emily Stell
- Adrienne D Stephens
- Kenneth Stephens
All providers in Monticello, AR · Home Health Agency in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.