Provider Demographics
NPI:1538561188
Name:ASSISTED CARE FOR SENIORS
Entity type:Organization
Organization Name:ASSISTED CARE FOR SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-942-4700
Mailing Address - Street 1:P.O. BOX 538
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150
Mailing Address - Country:US
Mailing Address - Phone:870-942-4700
Mailing Address - Fax:870-942-4184
Practice Address - Street 1:102 CENTER STREET
Practice Address - Street 2:SUITE A
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150
Practice Address - Country:US
Practice Address - Phone:870-942-4700
Practice Address - Fax:870-942-4184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care