Provider Demographics
NPI:1275237786
Name:DIVERSIFIED ADULT DAY SERVICES
Entity Type:Organization
Organization Name:DIVERSIFIED ADULT DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-347-3599
Mailing Address - Street 1:448 S ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:AR
Mailing Address - Zip Code:72360-2753
Mailing Address - Country:US
Mailing Address - Phone:870-821-5005
Mailing Address - Fax:870-821-5006
Practice Address - Street 1:448 S ALABAMA ST
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:AR
Practice Address - Zip Code:72360-2753
Practice Address - Country:US
Practice Address - Phone:870-821-5005
Practice Address - Fax:870-821-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care