Provider Demographics
NPI:1275544991
Name:CARE IV, INC.
Entity Type:Organization
Organization Name:CARE IV, INC.
Other - Org Name:CARE IV HOME HEALTH HOT SPRINGS
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 1:100 RIDGEWAY ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7145
Mailing Address - Country:US
Mailing Address - Phone:501-623-5656
Mailing Address - Fax:501-623-5727
Practice Address - Street 1:100 RIDGEWAY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7145
Practice Address - Country:US
Practice Address - Phone:501-623-5656
Practice Address - Fax:501-623-5727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4326251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR149955738Medicaid
AR10616OtherBCBS PROVIDER NUMBER
AR175822514Medicaid
AR175822514Medicaid