Provider Demographics
NPI:1528224581
Name:AMCARE SENIOR LIFE PARTNERS, INC
Entity Type:Organization
Organization Name:AMCARE SENIOR LIFE PARTNERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-880-1112
Mailing Address - Street 1:220 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-5134
Mailing Address - Country:US
Mailing Address - Phone:479-880-1112
Mailing Address - Fax:
Practice Address - Street 1:220 E 4TH ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-5134
Practice Address - Country:US
Practice Address - Phone:479-880-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR163629752Medicaid
AR167019765Medicaid
AR163628757Medicaid