Provider Demographics
NPI:1316556723
Name:ARKNASAS MAE COMPLETE SERVICES LLC
Entity Type:Organization
Organization Name:ARKNASAS MAE COMPLETE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-351-5606
Mailing Address - Street 1:3312 JERIDON CV
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8196
Mailing Address - Country:US
Mailing Address - Phone:870-351-5606
Mailing Address - Fax:
Practice Address - Street 1:3312 JERIDON CV
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-8196
Practice Address - Country:US
Practice Address - Phone:870-351-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care