Provider Demographics
NPI:1679113583
Name:DM PARKS INC., DBA COMFORT KEEPERS
Entity Type:Organization
Organization Name:DM PARKS INC., DBA COMFORT KEEPERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-498-6560
Mailing Address - Street 1:5068 N ARKANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-8325
Mailing Address - Country:US
Mailing Address - Phone:479-498-6560
Mailing Address - Fax:479-498-6568
Practice Address - Street 1:5068 N ARKANSAS AVE
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802-8325
Practice Address - Country:US
Practice Address - Phone:479-498-6560
Practice Address - Fax:479-498-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care