Provider Demographics
NPI:1083633952
Name:NEWPORT HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:NEWPORT HOME CARE SERVICES LLC
Other - Org Name:HARRIS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR. OF BUSINESS OFFICE SUPPOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:1205 MCLAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-3533
Mailing Address - Country:US
Mailing Address - Phone:870-523-0390
Mailing Address - Fax:870-523-0393
Practice Address - Street 1:1301 MCLAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3633
Practice Address - Country:US
Practice Address - Phone:870-523-0390
Practice Address - Fax:870-523-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3946251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR17052OtherBCBS PROVIDER NUMBER
AR112870732OtherPERSONAL CARE PROVIDER NU
AR102853514Medicaid
AR112870732OtherPERSONAL CARE PROVIDER NU