Organization
OZARK ADULT PERSONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL WILES (OWNER)
(870) 368-4419
Entity
Organization
Contact information
Practice address
1234 E MAIN ST, MELBOURNE, AR 72556-9316
(870) 368-4419
(870) 368-4094
Mailing address
PO BOX 906, MELBOURNE, AR 72556-0906
(870) 368-4419
(870) 368-4094
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190744752
—
AR
05
—
190746757
—
AR
05
—
192867796
—
AR
05
—
192868797
—
AR
05
—
193026732
—
AR
Enumeration date
08/28/2012
Last updated
09/23/2019
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