Provider Demographics
NPI:1275520652
Name:CARE IV, INC.
Entity Type:Organization
Organization Name:CARE IV, INC.
Other - Org Name:CARE IV HOME HEALTH LITTLE ROCK
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT/GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-686-2400
Mailing Address - Street 1:1023 RUSHING CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2498
Mailing Address - Country:US
Mailing Address - Phone:501-686-2400
Mailing Address - Fax:501-686-2499
Practice Address - Street 1:1023 RUSHING CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2498
Practice Address - Country:US
Practice Address - Phone:501-686-2400
Practice Address - Fax:501-686-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3939251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10603OtherBCBS ARKANSAS
AR142848738Medicaid
AR142848738Medicaid
AR142848738Medicaid