Organization
CENTERWELL CERTIFIED HEALTHCARE CORP.
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED OFFICIAL)
(479) 452-0424
Entity
Organization
Contact information
Practice address
2120 S WALDRON RD BLDG C, FORT SMITH, AR 72903-3689
(479) 452-0424
(479) 452-0960
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013100P
AR-COMMERCIAL NUMBER
—
01
—
047038
AR-COMMERCIAL NUMBER
—
01
—
0564382
AR-COMMERCIAL NUMBER
—
01
—
112135
AR-COMMERCIAL NUMBER
—
01
—
11341402450
AR-COMMERCIAL NUMBER
—
01
—
115712
AR-COMMERCIAL NUMBER
—
05
—
129054514
—
AR
05
—
129054514 (AR)
—
AR
05
—
129056732
—
AR
05
—
138789752
—
AR
05
—
138832757
—
AR
05
—
138833742
—
AR
05
—
140555765
—
AR
05
—
145450752
—
AR
05
—
145487738
—
AR
05
—
145489757
—
AR
05
—
145688732
—
AR
Enumeration date
07/07/2006
Last updated
11/30/2023
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