Provider Demographics
NPI:1245467166
Name:ELDER HOUSE ADULT DAY CARE CENTER
Entity type:Organization
Organization Name:ELDER HOUSE ADULT DAY CARE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-864-9316
Mailing Address - Street 1:615 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-5766
Mailing Address - Country:US
Mailing Address - Phone:870-864-9316
Mailing Address - Fax:870-875-1122
Practice Address - Street 1:615 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-5766
Practice Address - Country:US
Practice Address - Phone:870-864-9316
Practice Address - Fax:870-875-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No251J00000XAgenciesNursing Care