Provider Demographics
NPI:1235788829
Name:CHK LLC
Entity Type:Organization
Organization Name:CHK LLC
Other - Org Name:PLEASANT HILL ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:GWATNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:501-777-9500
Mailing Address - Street 1:3418 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-6001
Mailing Address - Country:US
Mailing Address - Phone:501-777-9500
Mailing Address - Fax:501-481-8926
Practice Address - Street 1:3418 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-6001
Practice Address - Country:US
Practice Address - Phone:501-777-9500
Practice Address - Fax:501-481-8926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-06
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5586Medicaid