Provider Demographics
NPI:1033789482
Name:COMMUNITY CAREGIVERS LLC
Entity Type:Organization
Organization Name:COMMUNITY CAREGIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:501-428-6525
Mailing Address - Street 1:915 OAK ST STE 1005
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4371
Mailing Address - Country:US
Mailing Address - Phone:501-932-1897
Mailing Address - Fax:501-300-5871
Practice Address - Street 1:915 OAK ST STE 1005
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4371
Practice Address - Country:US
Practice Address - Phone:501-932-1897
Practice Address - Fax:501-300-5871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care