Provider Demographics
NPI:1184497927
Name:SIMPLY HUMBLE BEGINNINGS LLC
Entity type:Organization
Organization Name:SIMPLY HUMBLE BEGINNINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:NIGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-291-6604
Mailing Address - Street 1:PO BOX 11201
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-0022
Mailing Address - Country:US
Mailing Address - Phone:501-291-6604
Mailing Address - Fax:
Practice Address - Street 1:2925 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-8100
Practice Address - Country:US
Practice Address - Phone:501-291-6604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health