Provider Demographics
NPI:1093427510
Name:SOUTHERN CAREGIVERS OF JONESBORO
Entity Type:Organization
Organization Name:SOUTHERN CAREGIVERS OF JONESBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-701-9122
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0399
Mailing Address - Country:US
Mailing Address - Phone:501-701-9122
Mailing Address - Fax:
Practice Address - Street 1:270 SOUTHWEST DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5829
Practice Address - Country:US
Practice Address - Phone:501-463-9990
Practice Address - Fax:870-606-2698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care