Organization
MENA MEDICAL CENTER HOME HEALTH, LLC
Active
Other names
Elite Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
605 MAGNOLIA AVE, MENA, AR 71953-3009
(479) 394-1812
(479) 394-1929
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
AR4410
AR
251E00000X
Home Health Agency
Primary
AR5123
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159676514
—
AR
01
—
17133
ARKANSAS BLUE CROSS BLUE
AR
Enumeration date
10/24/2006
Last updated
01/08/2024
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