Organization
STALEY HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTI STALEY (CEO)
(770) 490-9973
Entity
Organization
Contact information
Practice address
804 COLUMBIA, HELENA, AR 72342-2816
(770) 490-9973
Mailing address
804 COLUMBIA, HELENA, AR 72342-2816
(770) 490-9973
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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