Provider Demographics
NPI:1255466322
Name:AREA AGENCY ON AGING OF SOUTHWEST ARKANSAS
Entity type:Organization
Organization Name:AREA AGENCY ON AGING OF SOUTHWEST ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SNEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-234-7410
Mailing Address - Street 1:PO BOX 1863
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-1863
Mailing Address - Country:US
Mailing Address - Phone:870-234-7410
Mailing Address - Fax:870-234-6804
Practice Address - Street 1:600 COLUMBIA 11
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753
Practice Address - Country:US
Practice Address - Phone:870-234-7410
Practice Address - Fax:870-234-6804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR92606332U00000X
AR251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332U00000XSuppliersHome Delivered Meals
Not Answered251B00000XAgenciesCase Management