Provider Demographics
NPI:1417197245
Name:ST. FRANCIS HOUSE NWA, INC
Entity Type:Organization
Organization Name:ST. FRANCIS HOUSE NWA, INC
Other - Org Name:COMMUNITY CLINIC SILOAM SPRINGS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMINGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-751-7417
Mailing Address - Street 1:500 S MOUNT OLIVE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-3602
Mailing Address - Country:US
Mailing Address - Phone:479-751-7417
Mailing Address - Fax:479-751-4898
Practice Address - Street 1:500 S MOUNT OLIVE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3602
Practice Address - Country:US
Practice Address - Phone:479-751-7417
Practice Address - Fax:479-751-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR041869Medicare Oscar/Certification