Provider Demographics
NPI:1164436317
Name:CRITTENDEN CARES, INC
Entity Type:Organization
Organization Name:CRITTENDEN CARES, INC
Other - Org Name:PROCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:CASHMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:870-735-1500
Mailing Address - Street 1:PO BOX 3026
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72303-3026
Mailing Address - Country:US
Mailing Address - Phone:870-732-3353
Mailing Address - Fax:870-732-2662
Practice Address - Street 1:308 S RHODES ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4215
Practice Address - Country:US
Practice Address - Phone:870-732-3353
Practice Address - Fax:870-732-2662
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRITTENDEN CARES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-27
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4269251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10530OtherBLUE CROSS BLUE SHIELD