Organization
ARKANSAS 1ST CLASS CONSUMER DIRECTED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ROCHELL EDMONDSON (CEO/OWNER)
(573) 391-0570
Entity
Organization
Contact information
Practice address
825 E MAIN ST STE I, BLYTHEVILLE, AR 72315-2599
(573) 391-0570
Mailing address
825 E MAIN ST STE I, BLYTHEVILLE, AR 72315-2599
(573) 391-0570
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
VA
AR
05
—
000000000
—
AR
Enumeration date
10/15/2020
Last updated
10/15/2020
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