Organization
LEGACY OF WEST MEMPHIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA HODGES (OWNER/PARTNER)
(870) 394-9133
Entity
Organization
Contact information
Practice address
704 CALVIN AVERY DR STE A, WEST MEMPHIS, AR 72301-6536
(870) 394-9133
Mailing address
704 CALVIN AVERY DR STE A, WEST MEMPHIS, AR 72301-6536
(870) 394-9133
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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