NPIMap

Organization Active NPI

South Arkansas Developmental Center

  • In Home Supportive Care Agency
  • El Dorado, AR
National Provider Identifier
1760705339
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SOUTH ARKANSAS DEVELOPMENTAL CENTER
Practice address
714 W Grove St
El Dorado, AR 71730-4416
Phone
(870) 863-8194
NPI assigned
Mar 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Authorized official

Name
Mrs. Barbara Staggs
Title
Business Manager
Phone
(870) 863-8194

Specialties & licenses 1

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

Addresses

Primary practice location

714 W Grove St
El Dorado, AR 71730-4416

Mailing address

714 W Grove St
El Dorado, AR 71730-4416

Other identifiers 1

IdentifierTypeStateIssuer
165057772MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
South Arkansas Developmental Center for Children and Families5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1760705339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W GROVE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W GROVE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304416",
            "telephone_number": "870-863-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "STAGGS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "870-863-8194",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165057772",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.