Provider Demographics
NPI:1609037407
Name:ATLIS, INC.
Entity Type:Organization
Organization Name:ATLIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-741-7512
Mailing Address - Street 1:PO BOX 2267
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602-2267
Mailing Address - Country:US
Mailing Address - Phone:870-741-7512
Mailing Address - Fax:870-741-0890
Practice Address - Street 1:524 N SPRING ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-3528
Practice Address - Country:US
Practice Address - Phone:870-741-7512
Practice Address - Fax:870-741-0890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4391251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health