Provider Demographics
NPI:1497429922
Name:UNDER GOD WE CARE SENIOR CARE LLC
Entity Type:Organization
Organization Name:UNDER GOD WE CARE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHISM
Authorized Official - Suffix:
Authorized Official - Credentials:HCA, LIA, MA, CNA
Authorized Official - Phone:501-259-2851
Mailing Address - Street 1:903 TOWERING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-4853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:903 TOWERING OAKS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-4853
Practice Address - Country:US
Practice Address - Phone:501-259-2851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care