Organization
SOUTHERN CAREGIVERS OF STAR CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WATSON (OWNER)
(870) 904-4277
Entity
Organization
Contact information
Practice address
1771 GREEN HILLS RD, STAR CITY, AR 71667-8304
(870) 308-5132
Mailing address
709 COVENANT PL, SEARCY, AR 72143-6746
(870) 308-5132
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23540757
—
AR
05
—
235433797
—
AR
05
—
235434732
—
AR
Enumeration date
09/20/2019
Last updated
09/20/2019
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