Sources For Community Independent Living Services, Inc.

LBN: Sources For Community Independent Living Services, Inc.
Sources For Community Independent Living Services, Inc. is an health care organization with primary practice located at 1918 N Birch Ave , Fayetteville AR 72703-2408. The organization recently has only one registered license in Agencies / Case Management, which is considered as the primary health care specialty. Sources For Community Independent Living Services, Inc. can be contacted via phone (479) 442-5600, or through Mather, Jim via phone (479) 442-5600.

Contact Information

Primary practice address
1918 N Birch Ave Fayetteville AR 72703-2408
Phone: (479) 442-5600
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mather, Jim
Phone: (479) 442-5600

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X CS014 Arkansas

Profile Details

NPI number 1043583412
LBN Legal business name Sources For Community Independent Living Services, Inc.
DBA Doing business as
Authorized official Mather, Jim
Entity Organization
Organization subpart 1 No
Enumeration date Feb 16th, 2012
Last updated Feb 16th, 2012 - about 14 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 1043583412 NPPES
Arkansas MEDICAID 164857798

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