Organization
BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER
Active
Other names
Elite Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH E SANDERS (ADMINISTRATOR / CEO)
(870) 352-6363
Entity
Organization
Contact information
Practice address
310 W COLLEGE, FORDYCE, AR 71742-2230
(870) 352-6363
(870) 352-6343
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
AR4115
AR
251J00000X
Nursing Care Agency
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148415514
—
AR
01
—
17169
BCBS
AR
Enumeration date
10/10/2006
Last updated
10/17/2017
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