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Organization

SOUTHERN HOME CARE ASSISTANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACEY R PHILYAW (OFFICE MANAGER)
(501) 525-8886
Entity
Organization

Contact information

Practice address
2836 MALVERN AVE STE G, HOT SPRINGS, AR 71901-8363
(501) 525-8886
Mailing address
2836 MALVERN AVE STE G, HOT SPRINGS, AR 71901-8363
(501) 525-8886

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206214797
AR
Enumeration date
11/03/2015
Last updated
11/03/2015
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