Organization
AREA AGENCY ON AGING OF SOUTHEAST ARKANSAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY C TYNES (EXECUTIVE DIRECTOR)
(870) 543-6300
Entity
Organization
Contact information
Practice address
709 E 8TH AVE, PINE BLUFF, AR 71601-5010
(870) 543-6300
(870) 534-2152
Mailing address
PO BOX 8569, PINE BLUFF, AR 71611-8569
(870) 543-6300
(870) 534-2152
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102989732
—
AR
05
—
103043514
—
AR
05
—
120446752
—
AR
05
—
120447753
—
AR
05
—
120448757
—
AR
05
—
120723765
—
AR
05
—
128091738
—
AR
05
—
132845715
—
AR
05
—
146247754
—
AR
01
—
17030
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/19/2006
Last updated
05/30/2019
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