# TEAM 4 ULTIMATE CARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TEAM 4 ULTIMATE CARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619888047
- **Legal business name:** TEAM 4 ULTIMATE CARE
- **Authorized official:** KRESTON TYRELL GIBBS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (870) 807-3639

## Contact information

- **Practice address:** 1122 N PINE ST, FORDYCE, AR 71742-7009
- **Practice address phone:** (870) 807-3639
- **Practice address fax:** (501) 575-6093
- **Mailing address:** 1122 N PINE ST, FORDYCE, AR 71742-7009
- **Mailing address phone:** (870) 807-3639
- **Mailing address fax:** (501) 575-6093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/15/2026
- **Last updated:** 09/15/2026