Provider Demographics
NPI:1831384668
Name:REDEEM ADULT DAY HEALTHCARE
Entity type:Organization
Organization Name:REDEEM ADULT DAY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:DORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-541-0377
Mailing Address - Street 1:1604 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601-6822
Mailing Address - Country:US
Mailing Address - Phone:870-541-0377
Mailing Address - Fax:870-541-0386
Practice Address - Street 1:1604 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71601-6822
Practice Address - Country:US
Practice Address - Phone:870-541-0377
Practice Address - Fax:870-541-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care