Organization
THESE OLD BONEZ ENTERPRISES
Active
Parent organization
THESE OLD BONEZ ENTERPRISES
Other names
These Old Bonez Enterprises
Organization subpart
Yes
Provider details
NPI number
Legal business name
THESE OLD BONEZ ENTERPRISES
Authorized official
SHERESE GREEN (PRESIDENT)
(187) 051-4938
Entity
Organization
Contact information
Practice address
2144 HWY147 SOUTH- BUILDING A, PROCTOR, AR 72376-2346
(870) 277-0082
(901) 205-0597
Mailing address
PO BOX 1298, WEST MEMPHIS, AR 72303-1298
(870) 514-9383
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
AR
251J00000X
Nursing Care Agency
—
—
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
AR
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063919892
—
AR
05
—
229140797
—
AR
05
—
232529732
—
AR
01
—
33859
DHS
AR
Enumeration date
04/09/2018
Last updated
05/07/2021
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