Organization Active NPI

In God's Hands Transitional Living Home, Inc.

  • Case Management Agency
  • Magnolia, AR
National Provider Identifier
1790121721
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
IN GOD'S HANDS TRANSITIONAL LIVING HOME, INC.
Practice address
1032 Mullins
24
Magnolia, AR 71753-3380
Phone
(870) 949-7758
NPI assigned
May 16, 2013
Last updated
May 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Mrs. Ye Juanda Sargent
Title
Executive Director
Phone
(870) 949-7758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1032 Mullins
24
Magnolia, AR 71753-3380

Mailing address

1032 Mullins
24
Magnolia, AR 71753-3380
Phone (870) 949-7758

Other identifiers 2

IdentifierTypeStateIssuer
196258763MedicaidAR
196133746MedicaidAR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1790121721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 MULLINS",
            "address_2": "24",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533380",
            "telephone_number": "870-949-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 MULLINS",
            "address_2": "24",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533380",
            "telephone_number": "870-949-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN GOD'S HANDS TRANSITIONAL LIVING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "SARGENT",
        "authorized_official_first_name": "YE JUANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "870-949-7758",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196258763",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196133746",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.