Provider Demographics
NPI:1265448468
Name:CAVHS
Entity Type:Organization
Organization Name:CAVHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RNP
Authorized Official - Phone:501-257-6850
Mailing Address - Street 1:2307 REDBUD COVE
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-4779
Mailing Address - Country:US
Mailing Address - Phone:501-315-2969
Mailing Address - Fax:
Practice Address - Street 1:2307 RED BUD CV
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-4779
Practice Address - Country:US
Practice Address - Phone:501-315-2969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP01150282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access