Provider Demographics
NPI:1346607645
Name:ALLCARE HOMECARE LLC
Entity Type:Organization
Organization Name:ALLCARE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BOLING
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:870-933-2273
Mailing Address - Street 1:521 SOUTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5870
Mailing Address - Country:US
Mailing Address - Phone:870-933-2273
Mailing Address - Fax:
Practice Address - Street 1:101 S WASHINGTON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-3859
Practice Address - Country:US
Practice Address - Phone:870-280-2523
Practice Address - Fax:870-280-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR5162251B00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR200399754Medicaid
AR192793757Medicaid
AR192604752Medicaid
AR193931797Medicaid
AR19277798Medicaid
AR193932796Medicaid
AR194779765Medicaid