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Organization

STATE OF ARKANSAS

Active
Other names
Arkansas Department of Health Hospice 6
Organization subpart
No

Provider details

NPI number
Authorized official
MS. GAYLA LANUM R.N. (HOSPICE DIRECTOR)
(501) 661-9628
Entity
Organization

Contact information

Practice address
207 S JEFFERSON, COLUMBIA COUNTY HEALTH UNIT, MAGNOLIA, AR 71753-3901
(501) 661-2698
(501) 280-4626
Mailing address
5800 W 10TH ST, SUITE 300, LITTLE ROCK, AR 72204-1752
(501) 661-2698
(501) 280-4626

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
AR3636
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123489747
AR
01
AR3606
AR STATE HOPSICE LICENSE
AR
Enumeration date
07/01/2006
Last updated
10/09/2012
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