# SOUTHERN CAREGIVERS OF DE QUEEN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679285191
- **Authorized official:** JENNIFER HOOPER (QUALITY DIRECTOR)
- **Authorized official phone:** (501) 701-9122

## Contact information

- **Practice address:** 211 W DEQUEEN AVE, DE QUEEN, AR 71832-2809
- **Practice address phone:** (501) 463-9990
- **Practice address fax:** (870) 455-0087
- **Mailing address:** PO BOX 399, MAGNOLIA, AR 71754-0399
- **Mailing address phone:** (501) 701-9122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 3747A0650X | Attendant Care Provider | — | NULL | — |
| 3747A0650X | Attendant Care Provider | — | — | — |
| 3747P1801X | Personal Care Attendant | — | NULL | — |
| 3747P1801X | Personal Care Attendant | — | — | — |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 12/15/2022
- **Last updated:** 12/15/2022