Organization
SOUTHERN CAREGIVERS OF BENTONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HOOPER (QUALITY DIRECTOR)
(501) 701-9122
Entity
Organization
Contact information
Practice address
1400 SW SUSANA ST STE 6, BENTONVILLE, AR 72713-7877
(501) 463-9990
(479) 974-8978
Mailing address
PO BOX 399, MAGNOLIA, AR 71754-0399
(501) 701-9122
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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