Provider Demographics
NPI:1811385602
Name:PA AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:PA AND ASSOCIATES LLC
Other - Org Name:HUCKEBY HOUSE ADULT DAY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:COBERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:479-858-9827
Mailing Address - Street 1:3808 BUNKER HILL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-6978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 SHADOW OAKS DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-6046
Practice Address - Country:US
Practice Address - Phone:479-858-9827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care