Providence Pcc Of Springdale

LBN: Providence Pcc Of Springdale
Providence Pcc Of Springdale is an health care organization with primary practice located at 2175 Orchard St , Springdale AR 72764-6357. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Providence Pcc Of Springdale can be contacted via phone (479) 750-1511, or through Ching-Long, Autumn via phone (479) 750-1511.

Contact Information

Primary practice address
2175 Orchard St Springdale AR 72764-6357
Phone: (479) 750-1511
Fax: (479) 750-2214
Website:
Map and Directions
Authorized official contact:
Name: Ching-Long, Autumn
Phone: (479) 750-1511

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 102 Arkansas

Profile Details

NPI number 1740645456
LBN Legal business name Providence Pcc Of Springdale
DBA Doing business as
Authorized official Ching-Long, Autumn
Entity Organization
Organization subpart 1 No
Enumeration date Dec 22nd, 2015
Last updated Dec 22nd, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740645456 NPPES
Arkansas MEDICAID 207728794

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