Provider Demographics
NPI:1710679451
Name:CARECO HOMECARE AGENCY
Entity Type:Organization
Organization Name:CARECO HOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-557-3888
Mailing Address - Street 1:6834 CANTRELL RD # 2099
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4135
Mailing Address - Country:US
Mailing Address - Phone:501-577-3888
Mailing Address - Fax:501-333-9192
Practice Address - Street 1:4700 W COMMERCIAL DR STE B3
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8073
Practice Address - Country:US
Practice Address - Phone:501-557-3888
Practice Address - Fax:501-333-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care